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I had upper Asian blepharoplasty incision technique. Will the creases continue to look more even/go down? Hi doctors. I am very worried regarding my eyes. It has been post-op nine 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.

Thank you for your question. You had an incisional Asian eyelid procedure nine weeks ago. You submitted a photo which shows a certain amount of swelling afterwards and you're concerned about the heightened crease and whether you'll need revision surgery. Well, being a Cosmetic Oculofacial Plastic Surgeon for 20 years, I'm quite familiar with both the incisional and non-incisional procedures for Asian eyelid surgery and I have a lot of experience with revisional Asian eyelid surgery. So understanding what makes Asian eyelid surgery a little bit different than non-Asian eyelid surgery helps you understand why the swelling is the way it is.

So when we talk about incisional or non-incisional Asian eyelid surgery, there's one specific goal; to accomplish the development of a well-defined crease. And that is the connection of the skin at a specific height to the levator muscle or the levator aponeurosis. The levator muscle is the muscle that lifts the eyelid, like the word elevator. Now, in order to do that, whether it's a non-incisional or incisional, we're placing sutures from the skin to that muscle. And in a way, by doing that, there's a little bit of a tight space between the eyelash margin and the crease.

Because of that tight space, there's a tendency to develop swelling. That swelling can temporarily elevate that crease, making the crease look like it's much too high. And so I suspect your doctor probably advised you of this, but what I tell my patients is this swelling can linger. I have had patients whose swelling from the eyelash to the crease has actually lasted a year. And so when we see our patients, we see our patients in regular intervals, usually at about one week for suture removal, then one month, three months, six months, ongoing. And of course, with the door always open between those visits if they have any concerns.

We've always observed that there's a dynamic nature to this procedure in terms of the ultimate result. At certain point, one eyelid can be more swollen than the other. The creases can look a little bit isometric. They can look like this. They're too swollen one side. Or a little bit swelling on the eyes can go a long way and have a tremendous impact on the appearance of the eyes.

When I do the surgery, I essentially do this in ways that I can be very accurate in terms of the predictability. And in some cases, I'll actually have the patient open their eyes at a certain point. Of course, they don't feel anything but they will. I'll have them open their eyes and I can see how things look. And in other cases, especially if we're doing ptosis surgery at the same time, we'll actually sit the patient up and look at them to see how things look before some of the swelling starts to occur.

So my recommendation is meet with your original doctor who did your surgery. It is only nine weeks since the time of your surgery. And of course, you should be able to express your concerns and get an understanding of what to expect moving forward. So I think that you will probably be best of just waiting, but of course, communicate with your doctor to anticipate how things are going and to understand where you are in the healing process.

So I hope that was helpful. I wish you the very best of luck, and thank you for your question.

Asian Eyelid Surgery Post-Op Swelling: Is This Normal?

Dr. Amiya Prasad details the causes of temporary swelling after Asian/double eyelid surgery. The temporary swelling will subside given more time in the healing process.

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