Asian Eyelid Revision Possible? (photo)

i had my eyelids done 1 month ago in japan,the incision is asymmetrical and they didnt remove the fats especially in the outer corner of my eyes and thus making my eyes look droopy. I feel like it made my eyes to look like a triangle,because both inner and outer are droopy but the center is so wide and i am not happy with it. You can see in my photos when i close my eyes the lid below the incision looks so heavy and also my eyelashes are pointed downwards. photo of the eyelids i want included

Doctor Answers (4)

Early postop swelling after Asian eyelid surgery

+2

First, thanks for the photos to help with discussion. Since it's only been about one month from your surgery, it's important to allow for all the swelling and edema to subside before making final judgement about your result. Every surgery, however minor such as Asian eyelid surgery, requires proper recovery and healing period. From your photos, it appears that your are healing well and recovering as expected. Your final appearance will be stabilized in about 6 -12 months. At that point, then you can discuss final result in detail and perhaps consider revision to further improve your result. Make sure that the issues are significant and revision is worthwhile. Otherwise you may end it up worse than your current situation. Are you able to go back to your original surgeon and discuss your concern? If that's not feasible, then look for a board certified plastic surgeon who's experienced with Asian eyelid surgery.

Best Wishes,


Los Angeles Plastic Surgeon
4.5 out of 5 stars 23 reviews

Expected asymmetries during early recovery period after blepharoplasty

+1

For this point in your recovery, I would not be too critical of the outcome.  Swelling tends to resolve in an asymmetric fashion, and at 1 month post-op, you still have quite a bit to go.  Over the next 6-12 months as the edema subsides you will notice your crease descend as well, closer to the ideal picture you have generated.  Give your eyes a full year to heal before making any decision regarding a revision.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 19 reviews

This will not heal so as to be completely satisfactory to you.

+1

Your surgeon did a competent job on the eyelids.  For many, this would be completely acceptable work.  So please do not pick on your surgeon or make him fix the situations.  Your surgeon very likely did his or her very best work.  If they could have made your surgical outcome better, I am certain they would have done so.  So it is not reasonable to compel your surgeon to revise your surgery.  In fact your surgeon may very likely not really understand what your concerns are.  If they had the insight you are requiring of them, your surgery would have been performed differently.

 

Unfortunately you, like many looking for double fold surgery, need an outstanding job performed with finesse because small differences in an eyelid such as yours are highly visible.

 

First in my opinion, your eyelid incisions are not idea for your issues.  The incision was essentially made parallel to the floor.  I believe these incision should be contoured to match the shape of the eyelid margin with a slight flare in the lateral third of the eyelid and a degree of taper in the inner third.  Your incisions do not extend the width of the eyelid.  This means that no skin was removed from the eyelid which was necessary in your case. The right incision was made higher than the left incision (this generally indicates that your surgeon is left handed, the reverse occurs with right handed surgeons).  This makes the right crease appear too high.  No anchor blepharoplasty was performed to form the upper eyelid creases.  Essentially your eyelid platform skin was left loose, which now makes it look swollen but it is not swollen.  It is best to snug the eyelid platform skin and the orbicularis oculi muscle under this skin up to the eyelid crease.  This is accomplished by anchoring the skin and muscle to the levator aponeurosis.  Doing this in a very precise way also supports the eyelashes, which have been left ptotic by your surgery.  Unfortunately lash ptosis shades the cornea and makes the eyes look dull rather than bright like the picture of the eyelid you desire.   Compared to what you want to look like, both eyelids are overall slightly ptotic which will create options when you are ready for surgical revision.  Unfortunately to correct your recent eyelid surgery, all of these factors will need to be addressed.

 

I do agree with Dr. Kim that you may have a bit of softening in your appearance in time.  When he says that your eyelid will drop, he means your folds will not appear so high as swelling disappears.  This is generally true. However, for the reasons I have outline, I do not believe that you be satisfied with your final result.  I do recommend waiting 6 to 12 before considering revisional surgery which makes it possible to do very precise work.  I do recommend being extraordinarily careful in choosing your next surgeon.  And finally, to reiterate, do not return to your original surgeon for a revision.  While he or she will be very motivated to revise your surgery and otherwise make you happy, I strongly caution you that you may be even less happy with the revision that might be performed by this particular individual.

 

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 16 reviews

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At one month, your final eyelid position is not yet set

+1

There may some additional drop of the eyelid position over the next 1-2 months.  I would wait longer before considering a revision.  If you still are displeased, you should go back to discuss with your original surgeon before considering revision elsewhere. 

David W. Kim, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.