title: The effect of "single" vs "double" eyelids on the perceived attractiveness of Chinese women.
abstract: BACKGROUND
  A well-defined supratarsal crease has often been considered attractive, representing a significant component in a beautiful upper eyelid. Approximately 50% of East and Southeast Asian women are born with either a minimal or absent supratarsal eyelid crease. Among people of Chinese descent, the creation of a supratarsal crease ("double" eyelid blepharoplasty) is the most common cosmetic surgical procedure, but no comparative study has assessed the height by which an upper eyelid crease is deemed most attractive and depending on cultural background.
  
  
  OBJECTIVE
  The authors assess how attractiveness is interpreted by different cultural groups to determine whether double-eyelid blepharoplasty enhances attractiveness according to both Chinese and non-Chinese observers.
  
  
  METHODS
  Facial photographs were taken of 19 women of Chinese descent. The photographs were enhanced with computer imaging software to generate 3 additional pictures, depicting low, medium, and high upper eyelid creases on each model. Via an Internet-based survey tool, Chinese and non-Chinese observers were asked to rate the attractiveness of the faces with each potential eyelid position. (Surveys are available online at www.aestheticsurgeryjournal.com, as Appendix 1 and Appendix 2.)
  
  
  RESULTS
  Both Chinese and non-Chinese observers considered the medium-height upper eyelid crease most attractive (P < .00001). An absent upper eyelid crease was deemed the least attractive (P < .00001).
  
  
  CONCLUSIONS
  These preference data for eyelid height can be used to better counsel patients on perceived attractiveness and expectations for surgical results, since these results further elucidate which facial features are universally considered attractive.
authors.affiliation: Dr Hwang is a Staff Physician with the The Permanente Medical Group, Inc in the Department of Head & Neck Surgery, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California, and is a Clinical Instructor in the Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Harry S
authors.initials: HS
authors.lastname: Hwang
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Spiegel
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D001504:Beauty; D019882:Blepharoplasty / Q000379:methods*; D005143:Eyelids / Q000033:anatomy & histology* / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010781:Photography; D012984:Software; D055815:Young Adult
keywords: Asian eyelid; attractiveness; blepharoplasty; double eyelid; oculoplastics; supratarsal crease; upper eyelid