Asian blepharoplasty extremely large creases and uneven (Photo)

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.

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.