The larger size of manga eyes can range from subtle to unearthly, limited only by the imagination and skill of the illustrator. A similar phenomenon holds true with plastic surgery.
While aggressive skin removal can yield overly high creases and even interfere with eye closure, a most grievous error during double eyelid surgery is the removal of too much fat. When extreme, the deep loss allows the eyelid's thin skin and muscle to "collapse" into the underlying void, a feature that looks cute only in an illustration.
The medical name for an arched crease is "semilunar," a shape seldom found naturally on a young Asian face. When created after surgery, patients in East Asia often refer to this complication as "cartoon eyes."
Of course, what changes is not the eyes but the eyelids, although the optical illusion can be that of bigger eyes. What's so objectionable, however, is the unnatural rounding and deepening of the new eyelid creases, often accompanied by rippling of the deflated skin.
While removing skin and fat during cosmetic eyelid surgery is easy, putting it back can be difficult if not impossible. Better to be conservative when seeking surgery and limit any manga obsession to the comic books.
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