I had upper Asian blepharoplasty incision technique. Will the creases continue to look more even/go down? (Photo)

Hi doctors, I am very worried regarding my eyes. It has been post op 9 weeks since my upper blepharoplasty incision technique. The creases still are uneven. Will this continue to lower or be more even in time? How long? When should I get revision, if necessary? Many thanks

Doctor Answers (3)

Temporary swelling from the surgical healing process is still occurring. This will improve with time. I explain why it happens

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As a cosmetic oculofacial plastic surgeon for 20 years, I’m familiar with both the incisional and non-incisional procedures for eyelid surgery and I’ve had a lot of experience with revisional Asian eyelid surgery. Asian eyelid surgery is a bit different from non-Asian eyelid surgery. Incisional and non-incisional Asian eyelid surgery have one goal - a well defined crease. This goal is the connection of the skin to the levator muscle or the levator aponeurosis at a specific height. The levator muscle lifts the eyelid. In order to that, whether it’s the non-incisional or incisional, we place sutures from the skin to that muscle. By doing that, there’s a bit of a tight space between the eyelash margin and the crease. The tight space causes a tendency to develop swelling. That swelling can temporarily elevate the crease and make the crease look like it’s too high.

I suspect that your doctor probably explained this to you. I tell my patients that swelling can linger. I have had patients whose swelling from the eyelash to the crease lasted a year. We see and monitor our patients in a regular interval usually at one week for suture removal then one month, 3 months, 6 months and ongoing. The door is always open between those visits if they have any concerns. We always observed that there’s a dynamic nature to this procedure in terms of the ultimate result. At a certain point, one eyelid can be more swollen than the other. The creases can also look a little bit asymmetric and look like they’re too swollen on one side. A little bit of swelling can go a long way and can have tremendous impact on the appearance of the eyes.

I do the surgery in a way so I'm very accurate in the predictability of the outcome. In some cases, I can let the patient open their eyes at a certain point in the surgery, but of course they don’t feel anything. I have them open their eyes and I see how things look. In other cases, especially if we’re doing ptosis surgery at the same time, we have the patient sit up and look at the results before some of the swelling starts.

My recommendation is to meet with your original doctor who did your surgery. It is only 9 weeks since the time of your surgery , and you should be able to express your concerns and understand what to expect. Communicate with your doctor so that you know what to anticipate, and know where you are in the healing process. I hope that was helpful, I wish you the best of luck, and thank you for your question.


New York Oculoplastic Surgeon
4.5 out of 5 stars 25 reviews

Swelling and revision Asian eyelid surgery

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hello Kelly
The patient because 9 weeks is a little on the early side.  In particular if your eyes started out on even to begin with the healing process can appear asymmetric for a number of weeks and sometimes months.  Personally I have had some cases where 1 eyelid was anatomically very different from the other so the surgeries were quite different in each eye and it took about 2 months for them to even out.  I usually have a pretty good idea of what the outcome will be within a few months so there are instances where I have to have my patient's wait for the healing process to complete.  I understand you very nervous and anxious but give it more time.  Perhaps ask your doctor if there is anything you can do to speed up the recovery such as a steroid injection into the incision if needed.

Chase Lay, MD
Double board-certified facial plastic surgeon
Asian eyelid surgery specialists

Chase Lay, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 38 reviews

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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.