A sensitive topic that might offend a group of general practitioners, and this also serves as a fair warning to patients which you can use it as a guideline when selecting your doctors to perform a eyelid surgery on you.
2 things: what “Double Eyelid Surgery” means and the major duties of General Practitioners in Singapore – whether are they qualified to do this procedure.
The term double eyelid is a common term used in describing the crease that runs across the skin of the upper eyelid, and deepens into a folded skin when the eyes are open. The medical term for the double eyelid is “upper eyelid crease”, or “lid crease” for short, or “supratarsal crease”, or “supratarsal fold”.
The crease that is responsible for the double eyelid is due to fibrous connections between the underside of the eyelid skin and the levator muscle that pulls the eyelid upwards when the eye is opened.
Thus, when the eye is opened, the upward pull of the levator muscle also pulls the skin inwards along the line of the crease, deepening the crease and creating the fold. A lack of the aforementioned fibrous tissue connections between the underside of the skin and the levator muscle results in the absence of the crease and fold, which is apparently the absence of double eyelid. The absence of the double eyelid is extremely common amongst Oriental races, that is, Korean, Chinese, and Japanese. This is simply a genetic attribute of these races.
Double eyelid is mostly desirable because the absence of eyelid creases make the eyes look smaller, and less bright and alert. The eyelashes are also less visible because they tend to be angled downwards and inwards. In addition, skin laxity and puffiness tend to be more noticeable when they start to appear from aging. Thus, eyelids without a crease have the tendency to age earlier and faster. Therefore, when all other things are equal under normal circumstances, the presence of double eyelids ought to make the eyes look brighter, brighter, and more youthful, with more visible eyelashes angled more upwards and outwards. All of these turn out to give more attraction to the eyes. It is therefore a general knowledge that, in the absence of double eyelid creases, no matter how wonderful your eyes may look, they will look even greater with the double eyelid crease.
With the generally known importance of double eyelids, everybody desires to have it. This quest led to the innovation to create Temporary Double Eyelid. These temporary double eyelids can be created using glue or tape, but patients will have to live with the inconveniences of frequently applying these aids, mostly on a daily basis. In addition to these inconveniences, a long term usage is often associated with skin irritation that produces redness, itch and swelling. These are the reasons why users of tape and glue eventually seek a permanent, maintenance free, surgical solution to this problem.
Surgically, the key to producing the upper eyelid crease is to create, establish and maintain the missing connection between the levator muscle and the underside of the skin. This is achieved by using sutures (stitches) that connect those two structures along the line of the intended lid crease. The permanence of this result depends solely on the formation of adequate scar tissues. It then follows that enough scar tissue much be produced to avoid the crease becoming weaker with time, and may even eventually disappear. Placing more sutures in a more complicated manner and tying it more tightly are the key factors to producing more scar tissues which strengthens and stabilizes the skin to muscle connection and makes it more permanent.
Now, with all that has been said, this is therefore the main reason why the surgery must be performed by a specialist. Otherwise, complications will arise and the purpose of the operation may be forfeited.
General Practitioners on the other hand are medical doctors who treat acute and chronic illnesses and provide preventive care and heath education to the patients. They aren’t specialized in a particular area, which is why a sensitive case like this should be handled by certified personnel. Apparently, according to the Singapore Medical Council (SMC), only plastic surgeons and oculoplastic surgeons (a subspecialty of ophthalmology) are allowed by regulations to perform upper blepharoplasty, including double eyelid surgery.
Therefore, if ever a general Practitioner told you that he or she can perform a double eyelid surgery for you for whatever reasons, flee from them and call the police. Or at least call SMC (6372-3065) and report them.