How is Asian blepharoplasty performed? Possible ptosis or just swelling? (Photo)

I read that it takes 5-7-10 days for Asian upper eyelids to look presentable. I am 12 days past the surgery. Am wondering whether it's ptosis or the surgeon took out too much fat and unfortunately resulted in hollow appearance? I am extremely upset and regretting my decision for Asian blepharoplasty. Please let me know how long swelling will likely take to subside?Does blepharoplasty involve taking out a lot of fat from the eyes? Is dryness a permanent condition?

Doctor Answers 3

Asian blepharoplasty performed..

The "Asian Eye" refers to those with a low lid crease and is not exclusive to those of Asian descent. The Asian blepharoplasty is performed in a nearly identical fashion to classic blepharoplasty, though typically less lid tissue removal is required. The marking of the lid crease and the length and shape of the incision are the critical factors to a desirable outcome. The natural lid crease is marked across the length of the eyelid. The excess skin is also marked. The temporal end of the excision is extended slightly beyond the natural crease to maintain the low, flat angle of the natural lid. Sutures are used to close the skin margins and removed after approximately 10 days. There is often some temporary darkening of the incision following surgery but in nearly 100% of cases the incision becomes undetectable after several weeks.

Seattle Oculoplastic Surgeon
4.6 out of 5 stars 12 reviews

Healing from Asian blepharoplasty

good morning Ms. Lim

I'm sorry to hear about your stress but your story is not uncommon.  He will more than likely continue to heal and look good and much more symmetric as time goes on.  One question that needs to be answered is "was there are asymmetry of your eyes to begin with?".  If they were then your surgeon may have used slightly different techniques on one side versus the other to get asymmetric outcome.
In my own practice which is mostly Asian eyelid surgery about 30% of my cases are asymmetric to begin with and I used slightly different techniques on each side to get a symmetric outcome...  These cases I do find take longer to heal, sometimes up to 3 or 4 weeks.

Even in situations where he were symmetric to begin with you can have asymmetric healing in the first few weeks.  Please be patient and do your best not to cause your self to much stress.  Even though many patients do heal by 7-10 days many cases do take 2-4 weeks to really look presentable.  Fortunately, I am able to predict this with some reliability based on the patient's anatomy and skin type.  I'm sure you will do well and follow your surgeons directions.

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

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

The process of Asian blepharoplasty/ double eyelid surgery and why this is temporary swelling and not ptosis

Asian eyelid surgery recovery period is a little bit longer compared to a non-Asian eyelid procedure. There are some anatomic factors that involve an area of the eyelid called the pretarsal area. The pretarsal area is the space between the eyelid crease and the eyelashes. Asian eyelid surgery is done to create a crease on a person who has a little bit of extra skin or has almost no extra skin, but has fat that blocks the connection of the levator muscle -the muscle that lifts the eyelid.

In Asian eyelid surgery, we’re not removing a lot of fat because the more fat that is removed, the more relative hollowing the patient can get. Rather, we look to see if the fat will get in the way of the attachment that we are surgically creating. We’re taking the skin between the crease and the lashes and connecting it to the levator muscle which creates a tight compartment.

After the surgery, swelling usually occurs and it takes time for it to subside. I usually observe my patients closely in the first few weeks after the surgery to help them feel confident that what they are experiencing is normal. It is normal to have swelling from the crease to the eyelashes. In some people, that swelling can last for several months and subtle degrees of swelling can make a huge difference in the appearance. A lot of people will feel panicked that the crease is too high because the swelling of the pretarsal area causes the eyelid crease to look higher. So I always explain that where you are at one week to three months is going to be an evolution. If there are other factors such as sinus issues, allergies or even allergy to the antibiotic ointments, then they can prolong the swelling of the eyelids.

It is very important that you communicate with your doctor and not jump to conclusions about your appearance. Certainly people can look like they are hollowed out in the beginning. This is an area where there’s a dynamic architectural change. What I like to do during the surgery for most of my patients is let them open their eyes to take a look of how the eyelid creases in. It gives a window of opportunity to identify if the eyelid crease looks the way we intend it to look. If it looks good during surgery, then it’ll probably look good after surgery. There are also exceptions and sometimes revisions that are necessary but that’s a part of cosmetic surgery. In your situation, you’re probably early in drawing your conclusions and that you should communicate with your doctor about what your concerns are. Your doctor has your photos of you before surgery and can review with you what you can anticipate. Your concerns are consistent with the typical healing process related to Asian eyelid surgery. No one knows exactly what happened during surgery better than your surgeon so communication with your doctor is always very important. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

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.