Are some East Asian plastic surgeons watching too much anime? Art may indeed imitate life, but cosmetic surgery has no business imitating cartoons.
Two surgeons have, in their words, described a "novel surgical option" designed for "Asian patients desiring large oval eyes." Published in the January, 2011 issue of the Journal of Plastic and Reconstructive Surgery, the authors note that a rounded and retracted lower eyelid is "generally recognized as a symptom of aging or a complication after blepharoplasty" but then propose a "perceptional change" as they describe an elective cosmetic operation designed to achieve precisely such distortion.
In other words, Westernization trumps health and vision, so don't worry about it.
The operation seems designed to appeal to those Asian patients seeking cosmetic alteration of every last feature of their natural eyelid contour.
Since the two surgeons found 125 young patients willing to undergo such a conceptually offbeat procedure, one has to at least wonder whether the doctors were "selling" this operation or if their patients specifically requested it on their own without prompting, something that would be most uncommon in patients of Asian descent residing in the United States.
The operation permanently deforms the anatomy of the lower eyelid by surgically removing a crescent of skin from the lid's front surface and then tightening the eyelid retractors (tiny structures that move the lid downward when the eye looks down) along the lid's back surface.
What results is a mechanical shortage that tugs the lid down, thus creating the exact sort of anatomical train wreck that most Asian and non-Asian cosmetic surgeons strive to avoid at all costs.
Predictably, any up-slanting of the eyes was lessened and the lids appeared more opened vertically after the operation. Equally predictable were postoperative problems including incomplete eyelid closure and in-turning of the lashes against the eyeball, both of which were termed "minor complications" by the authors.
From a physiological point of view, the minimal increased upward excursion seen in some Asian lower lids is not determined in the least by either excess skin or loose eyelid retractors, so performing destructive surgery on these delicate tissues makes little sense.
Not only are the immediate anatomical deformity and interference with normal function predictable, but future effects on the health and appearance of the lids and eyes as young patients grow older are completely unknown.
This operation seems over-the-top, right up there with cosmetic leg lengthening and foot narrowing. While the surgery doesn't yet have a catchy name, "eye-o-plasty" seems a no-brainer.