Upper Eyelid Surgery - Incision Not in Crease? (photo)

See the placement of the incision but at this very very early healing stage I can not recommend anything more than observation. 

I agree with you that there seems to be a crease visible below the incision site. . There are a couple reasons this may be so.

First, not every patient has one eyelid crease. Some patients, as they age and the eyelid fat atrophies, the overlying skin will become more redundant and multiple creases may form. Your surgeon may have placed the incision in the more prominent crease. As others have mentioned, this may also have been done to make the incisions more symmetric.

Secondly, as others have mentioned, due to the postoperative swelling [and at three days, its probably at its worst] the incision site is very visible. As the swelling recedes, the incision will start to involute into the normal fold of the upper eyelid. Further more, eyelid swelling may also be asymmetric.

Now if all of the above resolves, and at three months, the incision scar is still visible, revision is still possible. A high crease can be lowered [if there is still enough residual skin present to allow eyes to close]

 

I see what you're commenting on; however, a this point all you can do is wait and see what happens.  If at the 6 month mark you can still see a crease below the incision, you should discuss revision with your surgeon.  I wouldn't suggest a revision before this time point, however.  

Also, you are clearly anxious about this - you should discuss this with your surgeon.  Perhaps we are being fooled by the post-operative swelling, and your surgeon did place the incision in your crease.  It's best to hear it from the horse's mouth, so to say.

Patience is the key for now.

Best of luck,

Asif Pirani, MD, FRCS(C)