Asian blepharoplasty extremely large creases and uneven (Photo)

Hi, I am extremely worried about my upper incision Asian blepharoplasty. I am having issues looking all the way up with my right eye, my creases are extremely huge and uneven, and I have some slight difficulty closing the right eye. Should I be concerned? My eyes were actually a lot nicer before blepharoplasty and am extremely regretful of this decision. :(

Doctor Answers 2

Temporary post-op swelling can remain for some time. Some revision may be needed later on but it's still too early to tell

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Asian eyelid surgery deals with a series of anatomic differences. It is a procedure that is used for the formation of an eyelid crease and a connection is made between the skin and the muscle that lifts the eyelid called the levator muscle. Unfortunately, when you create that type of connection, it results in a lot swelling between the eyelash margin and the eyelid crease called the pretarsal area. This swelling applies for both incisional and non-incisional Asian eyelid surgery.

Swelling can artificially elevate the appearance of the crease and it can be asymmetric. When we look at our patient’s results, we don’t finalize the results at one month or even three months, but confirm the results at six months to a year because eyelid swelling can last that long. For the majority of our patients for whom quick recovery is important, they are able to go back to work and go back to their normal life within a week of the surgery. True surgical healing for every cosmetic surgeon goes on for up to a year and this is particularly important in other surgeries as well such as face lifting surgery and rhinoplasty. With Asian eyelid surgery, the first month can be concerning to the patients but the succeeding months, things can certainly change and evolve.

In my practice, I see patients after a week to take the sutures out. We then see them after a month, 3 months, 6 months and so to make sure that healing is going on properly and that there’s no evidence of infection or any type of unusual response such as scarring. At the same time, it gives us an opportunity to document the progress so that we can really reassure our patients that what they are seeing is not permanent. In fact, when we do Asian eyelid surgery which we do in local anesthesia with sedation, I allow the sedation to become a little bit lighter so that the patient can be awake at a certain point and I can ask them to open their eyes. Although they won’t feel any pain or discomfort, when they open their eyes, it confirms for me at real time that the crease and everything that I wanted to set will set at the right place.

Certainly swelling is a factor that I think that you have to discuss with your surgeon about. It’s natural to be concerned but I think a dialogue with your surgeon is critically important for you to know what to anticipate. I’m sure you did your research before choosing your surgeon. If the surgeon has a lot of experience in Asian eyelid surgery, then it is unlikely that there is any kind of significant misadventure in your surgery. So go back to your original surgeon and have a discussion about swelling and what to anticipate. Should there be any enhancement necessary, for example in my practice, our doors are always open to our patients. Enhancement is the elastic nature of plastic and cosmetic surgery and sometimes you need to tweak a result or procedure to get the maximal potential benefit. If you’re still not satisfied, I’m sure you can look for second opinions if you so desire, but I think that your original doctor would probably be able to explain to you what’s going on with your eyelids. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Uneven postoperative appearance Asian eyelid surgery

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as it appears at the moment the adherence between the crease that was created and the levator tendon beneath is stronger and higher vs. the left.  This may be able to be released or relocated.  The tethering that you feel and your right eyelid is because the eyelid skin itself is wrapped around the bone or orbital rim when the tendon is pulling the eyelid open back into the eye socket.  This should continue to relax but may require some revision work.

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 76 reviews

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