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Woman: Can I reverse my double eyelid surgery by stretching the upper eyelid and making the crease lower? I had revision double eyelid surgery three months ago. Eyelids were created too high and distance between brow, crease and crease, eyelashes are the same. Is it possible to stretch the upper eyelid and make the crease lower? My preference is single eyelids. Also, I got prominent, long scars. Please, could you help me with any advice?

Dr. Prasad: Thank you for your question. You had Asian eyelid surgery done three months ago. You've expressed a concern about the precision of the eyelid crease being halfway between the eyelid margin and the brow. That you feel it's too high, and that you want to reverse the surgery, such that you have a single eyelid.

Well, first of all, the challenge after especially an incisional Asian eyelid procedure, it makes it almost impossible to get the results that you had before surgery.

So let me explain. When you have excisional procedure where you're removing skin, and you're also removing fat in order to connect the skin to the muscle, called the levator muscle. The word "levator" is like the word "elevator." It's a muscle responsible for lifting your eyelid.

When someone has a crease, there is... nature has allowed a kind of what's called an interdigitation or connection between the levator muscle and the skin. So it creates a crease. In surgery, we create that crease artificially with sutures. If you want to stretch your skin, you have a long time before the skin will stretch, before it becomes stretched enough that it will cover this area over.

But I'd also want you to also appreciate that three months after surgery, you're still in a healing phase. The process of healing is going to go on for up to a year. So when you talk to your doctor, I think that expressing your concerns is very important. With your eyes closed and the crease being in a particular position, it's not as relevant, especially once the incision heals, as what the eyes appear like with your eyes open. If there is a proper or appropriate and aesthetic fold of skin that shows a narrow type of eyelid shelf or platform, or as everyone else refers to it, as just the lid. Then it should look natural, and it should be satisfactory to what you wanted when you went in for Asian eyelid surgery.

In our practice, when a patient comes in, we will at times do something like fat grafting to fill an area that is where too much fat may have been removed, or the person naturally, with aging, lost fat. One of the things that is observed with people, with Asians of a particular anatomy is that you can have full eyelids when you're younger. But then, as you get older, the eyelids hollow out. So in addition to extra skin, the eyelids can look like there is actual volume or fat loss. So in those situations, we'll do fat grafting.

But I think you're going a little bit ahead of yourself at this point. What you should probably be as patient about the progression. You can't undo everything that's been done. Especially, like I said, If you've had skin removed and fat removed.

So meet with your doctor. Review your before pictures. Review your after photos, and see if there are ways that your doctor can help you get to a point where you will be satisfied with your result. So at this point... Again, the same advice, meet with your doctor. Hopefully as things settle out, you'll be more satisfied with the result. I hope that was helpful. I wish you the best of luck. Thank you for your question

Can Asian Eyelid Surgery Be Reversed?

Dr. Amiya Prasad discusses whether or not an Asian eyelid surgery can be reversed.

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