In Asia blepharoplasty is almost synonymous with blepharoplasty. The technique of blepharoplasty has been well established since Japanese surgeon Mikamo first reported the suture technique in 1896, and in 1960 Fernandez reported the most basic approach: excision of a portion of the skin, orbicularis oculi, orbital septum and orbital fat. The dermis is then fixed to the levator aponeurosis. After a series of invasive manipulation techniques, the 100-year-old suturing technique was then promoted by clinicians in many East Asian countries. The choice of eyelid surgery for Asian Orientals has changed over time, from the traditional type of eyelid, which seeks slight variations, to the invasive wide eyelid, and finally back to the non-scarring, conservative eyelid technique. The choice of suture material has not attracted much attention; practitioners tend to use absorbable gut, removable or permanent sutures. In the incisional technique, the tissue is secured between the skin and the lid plate or levator fascia, and in 1999, Park reported a technique for securing the orbicularis muscle tissue (not the skin) to the levator fascia, and Doxanas et al. demonstrated the anatomical basis for the lack of a crease in front of the lid plate in Asians compared with Caucasians. The absence of the attachment of the levator aponeurosis to the orbicularis oris muscle, the subluxation of the orbital septum to the levator aponeurosis, and the low prominence of the prelid fat are all considered to be factors such as single lids in Asian Orientals. The surgical operation is to design the anatomical features that produce the double eyelid. Although the incision technique can produce a more defined and permanent fold, more practitioners prefer to use that eclectic approach that is simple, effective and satisfying to the patient. Canthus correction has been largely overlooked due to the obvious scarring. The use of conservative narrower blepharoplasty for massed canthus does not compromise the cosmetic improvement of blepharoplasty. As the blepharoplasty style invades more widely, the inner canthus becomes more visible. It sometimes gives the appearance of round eyes. Importantly, the public’s expectation that surgery will enlarge the eyes has led surgeons to pursue better techniques to eliminate the medial canthus. A variety of procedures have been reported, including direct excision, V-Y advancement, W-plasty, and Z-plasty. Despite the many options available, many surgeons are reluctant to perform canthoplasty because of the potential for visible scar formation. The difficult to conceal scarring of the eye also reduces the need for this procedure. There is no denying that a successfully performed canthoplasty can beautify the eyelid without adding scarring. Therefore, I have designed a surgical approach specifically to address the issue of medial canthopexy scarring, the vertical V-Y plication, with excellent results that have been reported and promoted at national plastic surgery meetings. The scar of this method is more hidden than the traditional method, and the new inner canthus is natural, which is highly valued and praised by foreign colleagues, and the corresponding technical method is recommended to be published in the British Journal of Plastic and Cosmetic Surgery. Before and after surgery (2 years) Comparison Before and after surgery (1 year) Comparison