Lower Eyelid Extension Surgery

This is also called lower eyelid enlargement surgery. It originated in Japan. Because many females want to have round and big eyes like those of Ayumi Hamasaki, a Japanese star, this surgery was developed to achieve the extension of lower eyelids and exposure of inferior eyeballs. This method is mainly aimed to make the eyeballs bigger or more white eyeballs exposed at the lateral canthus by extending the horizontal line of the lower eyelid downward like the surgical creation of an eyelid extroversion or to improve the chronic problems of lower eyelid eyelash inversion. This surgery is conducted by making an incision at the lateral 1/2one-half of the lower eyelid and removing the partial medial tarsus at such a site before the resection of partial lower eyelid skins and the adjustment of the eyelid level and downward pulling degree. Because both parts of the tarsus and skin are excised, the tarsal line after stitching naturally extends downward to expose more eyeballs. Nevertheless, this surgery does not work for patients with small or short eyes. The excess enlargement of the lower eyelids causes complications such as eyelid ectropion, contrary to the significance and objective of the surgery. Therefore, Dr. Chuang suggests that patients should fully understand their eye conditions and surgical risks prior to the operation.

Surgical conditions


  • Type of anesthesia: IV sedation + local anesthesia
  • Surgical incision: An aApproximately 1-cm incision at the lateral side of the lower eyelid
  • Recovery: 3–5 days
  • Removal of stitches: 7 days

General instructions

No food and water on the day of surgery

  • Do not wear contact lens for 1 week postoperatively.
  • Avoid smoking, alcohol, and irritating foods for 1 month postoperatively.
  • Avoid staying up late, hard compression, and rubbing the eyes for 3 months postoperatively.

Ideal candidates

  • Patients with slim and long eyes that need to be enlarged
  • Those with congenitally excess coverage of the eyeballs by the lower eyelid (slanted eye)
  • Those who have the trouble of lower eyelid eyelash inversion
  • Those who desire extremely big eyes

Potential complications

  • Eyelid ectropion
  • Eyeball redness or sensitivity (temporary)
  • Exceedingly big eyeballs
  • Scarring
  • Incomplete results

Surgical advantages

  1. It improves chronic eyelash inversion over lower eyelid.

  2. It makes the eyeballs more exposed and bright.

  3. It is the ultimate method to maximally enlarge the eyeball size.

Surgical drawbacks

  1. It may incur the risks of lower eyelid ectropion.

  2. It may cause eye redness, tearing, or sensitivity temporarily.

  3. The enlargement degree may be unobvious due to the limitation of congenital eye shape.

  4. Future reversibility is low.

Possible procedures in conjunction

Before & After

These photographs represent typical results, but not everyone who undergoes plastic surgery will achieve the same.

Lower Eyelid Extension Surgery – Female