Asian Double Eyelid Surgery, for the Second Time?

Hello Rachel,
It is not unusual to have the lid height drop slightly over time. Your crease position was likely set at 6 or 7mm, but may have required some more skin excision at the time to enhance your new lid posiiton. Your result is overall very nice, very natural but I have treated a number of patients who have asked about the same concerns. I cannot tell if you need a medial epicanthoplasty (inner lid skin release), but since you are now 9 months out from surgery, you are in a safe time for revision. As the other surgeons have mentioned, revision is always more risky than the first surgery, just be sure your surgeon has ample experience. Good luck!

The question of whether or not it is worth the time and money to have a revision procedure is one that only you can answer, but your aesthetic goals could certainly be achieved during revision surgery with an experienced surgeon.  

It's reasonable to redo the double eyelid and also perform the epicanthoplasty. Ideally, combining your eyelid surgery with a browlift would give you a nicer result, but that may be more surgery than you want to undergo at this time.

In order to achieve a greater definition in the inner corner of the eyelid, you will require an incision in this area, This has the potential to create a visible scar and is generally not used for this reason,

Timing- 9 months is ok time to start thinking about revision, 12 months is probably a touch safer in principle especially if you're happy with the job your surgeon did.
Increasing the fold- this is possible and done frequently, the danger often is making the crease too high in the first place and THAT's more of a reason often a revision is sort coming from other places.
Cutting the corner of the eye- what's you're talking about there is epicanthoplasty, what us Korean Plastic surgeons call "front opening". It creates an impression of bigger eyes but also has the effect of Eurasianising the eyes too. But the biggest thing that give the bigger eyes impression is to add in a touch of ptosis correction which is to shorten the mechanism of eye opening with sutures, obviously this needs to be done with precision and precaution. Some times "back opening" or opening up of the corner of the eyes outward closer to your ears is done to change what we call a tilt but this is less noticeable and less of a "bang for a buck" and to be applied in only specific circumstances.
Safety- Make sure you go to see a qualified specialist plastic surgeon or oculoplastic surgeon in your area.
Wish you the best in your journey.
Dr Leo Kim, Specialist Plastic Surgeon in Sydney

Hello GirlfromNYC

 

it's reasonable to perform a revision surgery on your eyes. Is it worth the money? That's a question that you can only answer for yourself. However, so long as it is apparently safe and reliable based on your physical exam you can certainly make changes to the appearance of your crease at this stage postoperatively and at your apparent age. Get a few consults and ensure that these surgeons can show you a variety of different creases and plenty of photo evidence that they operate on Asian patients.

Best of luck

Chase Lay, MD

Double eyelid crease formation and epicanthoplasty can be done as a revision.  There are a few nuances that need to be considered in this situation.  Making a higher crease, will or may entail a higher incision and fixation at a higher point with also more skin excision.  It is usually easier than making a higher crease smaller. 
When you mention opening the corner of your eyes, do you mean the inner or outer corners.  The inner corners are more likely the area that will open your eyes more than the outer corners from a congenital standpoint.  Asian epicanthal folds are in the medial or inner corners of the eyes. This is what distinguishes Asians from Caucasians in many Asian people and not the outer corner of the eyes. 
I have seen many results from the outer corners being cut and they don't make as much difference as when the procedure in the inner part of the eyes are done.  One thing to remember is that most Asian appearing eyes have a crease that is 3mm or less when the eyes are open.  When they are larger they begin to take on more of a western caucasian look.  There are studies that validate this assertion in the literature.
Thanks for reading, Dr Young.

You said your doctor did a wonderful job.
Discuss your concerns with him/her. The surgery can be redone but carries a certain risk. The inner eye (you might be talking about the EPICANTHAL FOLD) can be repaired, but puts a scar on the inside of the eye.

You might be OK with a strengthening of the crease towards the nose. The problem is if it is cut there may be a more noticeable scar. Sometimes a suture technique can be used with less of a risk of a noticeable scar. Good Luck.

It sounds like your surgeon did well by you and that you have confidence in them. What is their advice? Perhaps see a few other surgeons and ask the question. More scars might detract from a nice result.
There is an old saying in surgery that "perfection is the enemy of good!" Watch out for this as further surgery might ruin the result you currently enjoy.