Dr. Lam lectures on the Asian eyelid and focuses on technique as well as a new classification for the aging Asian eyelid which he devised.
Dr. Lam has classified the aging Asian eyelid into three types: the aging Asian eyelid with a natural crease, the aging Asian eyelid without a natural crease, and the aging Asian eyelid that has a previously surgically made crease. Each scenario requires a different approach to attain the best results.
The aging Asian eyelid with a natural crease may be thought of as very similar to a standard Occidental eyelid. However, there is one major distinction. If the extra skin is simply removed from the upper eyelid for the aging Asian eyelid, the crease will oftentimes be made too high, which will appear unnatural. As mentioned, Dr. Lam believes that this higher crease also looks bad on the Caucasian patient but looks exceptionally unnatural in the Asian patient. Accordingly, if Dr. Lam needs to remove some extra skin for the individual with a natural crease, he will almost always perform fat grafting simultaneously to create the natural convexity of a youthful eyelid shape but also to maintain the eyelid crease height. Phrased another way, fat grafting permits maintenance of the eyelid crease height by pushing the eyelid crease back down to a natural height after skin removal alone raises the crease unnaturally.