It’s a fact: more and more ethnic minorities in America are choosing to have plastic surgery than ever before. Research has shown that from 2000 to 2005 there has been a 65 percent increase in the number of people from ethnic minority groups going under the knife for cosmetic reasons, and that statistic is steadily growing.

It is estimated that about 50 percent of all people of Asian descent have what is known as a "single fold" eye or mono-lid, with the existence of the crease often dependent on the country of origin. In Asia, double eyelid surgery is the most popular cosmetic procedure, although it takes third place among Asian-Americans in the US, just behind nose and boob jobs.

However, an increasing number of minorities are opting to have "ethnic plastic surgery", or procedures which some people see as being done solely to erase ethnic characteristics and make them conform more closely to the perceived white ideal. From nose jobs to narrow an African nose to eyelid operations to make an Asian eye appear more rounded, these procedures are gaining in popularity – although they are widely contested.

According to the American Society of Plastic Surgery, the following operations are the most popular among ethnic minority groups:

• Nose-reshaping: the most common op among African-Americans and Hispanics

• Breast augmentation: the second most popular procedure among Hispanics

• Breast reduction: the second most popular among Africa-Americans

• Blepharoplasty or eyelid surgery: the second most popular cosmetic operation among Asians

Asian Double Eyelid Surgery

It is estimated that about 50 percent of all people of Asian descent have what is known as a "single fold" eye or mono-lid, with the existence of the crease often dependent on the country of origin. In Asia, double eyelid surgery is the most popular cosmetic procedure, although it takes third place among Asian-Americans in the US, just behind nose and boob jobs.

Several tried-and-tested techniques are used to achieve this double eyelid, including:

Suture method. A series of tiny incisions along the crease line, and then tight sutures under the skin. When the skin is lifted and folded back a not completely natural-looking crease is made. Although this method is cheap and has good results, they are not permanent.

Full incision method. The surgeon makes an incision in a the shape of a half moon along the incision line, then strips of muscle, orbital septum and occasionally fat are taken out (these are also removed in traditional eyelid surgery). The two sides are then sewn permanently together, so the result is long-lasting and looks more natural, especially when the patient blinks.

Double Standard Twist (DST) method. Best of both worlds (in the immortal words of Hannah Montana). Fat is removed through incisions while sutures lift the lid. Less-invasive and can results can last as long as a decade.

Laser Surgery. Sutures create a new crease but lasers are used to take away excess fat, tissue and muscle. No cutting required and less bruising than with other methods.

Please note that there are risks and side-effects no matter what type of procedure you choose. These include infection, initial bruising and swelling, itching, eye gumminess and light sensitivity. Scarring can take up to six months to disappear – or more.

Why Do It?

Plastic surgeons who advertise double eyelid surgery are often quick to point out that they are not helping their patients look more Caucasian, but helping them to feel more confident and create a better personal look for them as individuals. Typically, they say that Asians approach them because they want to look more "bright-eyed", with eyes that appear wider.

According to some plastic surgeons, a single crease means the eye appears to be "taut and heavy", making the person appear older than they really are – even if they are in their twenties. They also say that having a single-fold eye means that make-up is more difficult to apply, and that it makes the eyelashes less visible.

"Many prospective patients say a single eyelid makes them look sleepy or tired and that it makes their eyes look too small," according to PlasticSurgery.com, which claims the first operation of the kind took place in Japan way back in 1896. "Most Asian patients don’t want to change the natural almond shape of their eyes, but just have eyelids that are less heavy looking, with brighter eyes."

People who are opposed to double eyelid surgery, however, say that the goal is to make one’s ethnicity appear less obvious. "Double eyelid surgery is unnatural and people who do it are buying into a beauty myth that is not Asian-based," says Martin Wong, editor of Asian art and culture magazine Giant Robot.

"It’s really just self-mutilation and a lot of it sadly is interjected by parents and their ideas. It’s heartbreaking that these young girls don’t have cultural pride; that they’re ashamed of who they are and how they look."

Others agree. "It’s clear to me that any person of color seeking to change their features to alter features associated with a particular ethnicity is trying to change their ethnic appearance," writes a self-acclaimed "angry Asian American woman" on her personal and political blog called Reappropriate. "As an Asian/Asian American woman, trying to enlarge one’s eyes (whether one is successful or not) is just a manifestation of racial/ethnic self-hate."

More Than Meets The Eye

While there is definitely more to beauty than meets the eye, the number of Asians having double eyelid surgery can attest to the fact that Asian blepharoplasty is here to stay. Some people continue to use eyelid glue or tape to achieve a crease, but why do that when surgery is available?

"Asian blepharoplasty is not a Westernizing surgery, but more of a feminizing procedure," writes Dr Benson Chen at AsianEyeMD.com. "This also explains why some men seek the procedure to make them appear more "friendly", and perhaps less masculine." Ummm, that makes sense!

If you are considering Asian blepharoplasty yourself, the choice is up to you. But no matter what you choose, make sure you do your homework and use only a Board-certified surgeon, preferably one who is a member of the American Society of Plastic Surgeons (ASPS) or its equivalent, who has carried out the procedure countless times before. Hopefully, you’ll be happy with the results!

The information in the article is not intended to substitute for the medical expertise and advice of your health care provider. We encourage you to discuss any decisions about treatment or care an appropriate health care provider.