Aegyo Sal is a relatively new technique in the world of Asian Plastic Surgery that entails creating fullness under the eyelashes to make the eyes look bigger. I first starting doing this about 5-6 years ago on my Asian Clients. Aegyo Sal is literally translated into "love (ae)" and "beautiful (gyo)" and sal is "skin". The procedure is more concentrated around the lower eyelid area where a small elevation or protuberance is created just under the eyelashes. This can be done with the use of fillers, fat injections and other materials like alloderm (acellular dermal matrix or cadaver irradiated skin) or goretex.
Below is a picture showing where the filler, fat injections, alloderm, goretex is placed to create the Aegyo Sal Asian Eyelift. It is located just beneath the eyelashes. Eyebags that are associated with aging is under this location. Placement of filler or material in the eyebag area will tend to make you look older and the Face look older. So placement of the material just under the eyelashes creates the effect that the Asian eyelift Aegyo Sal is attempting to do.
Fillers are done by making the eyelid numb by injecting local anesthesia to the nerve that is just under the eye. The infraorbital nerve controls the innervation to the eyelid. After the proper local anesthesia is achieved the filler is placed under the eyelashes in the area needed to create the effect and the Aegyo Sal Asian Eye Smile. This procedure is done in office and can be done in about 30 minutes. Most the time you will be left with extra filler that can be used. For this we like to fill the cheeks in order to help the face look youthful along with improving the Asian Eye Smile in this location. Fillers are said to last 6 months to a year. Some have been seen to last much longer in our experience.
With Fat injections this can also be done by taking fat from somewhere in your body and injecting fat in the same location. This procedure to be done under local anesthesia in our procedure room. We usually Harvest fat from the stomach or the legs and then we process the fat. After doing so we numb the lower eyelid in the same way as we do for the fillers and fat is injected just under the eyelashes. The advantage with fat is that it can be long lasting. Instead of 6 months to a year, the fat can last any where from 5-10 years depending on your genetics and other factors relating to your body and healing.
In terms of other materials such as Alloderm (irradiated cadaver skin) and Goretex the procedure can be done in multiple ways. First a small incision on each side of the eyelid can be created and a tunnel can be dissected. The product can then be pulled through with a special needle. The other approach is actually to make an incision all the way across and the material implanted and then the eyelid incision closed. Our preference is to use alloderm because it is natural. Goretex is not advocated given the location next to the eyelashes