No fold after blepharoplasty 10 days: Is 6mm too high for my eye? (Photos)

Thank you for your question. You think your eyes are smaller than expected 3 weeks after surgery, and you are worried it’s permanent. You add that one eyelid is flatter and more swollen than the other, and the inner corners go in straight instead of round. You are asking if there is anything you can do to improve this.
I can certainly help you based on your photo alone, and give you so guidance in the absence of a physical exam. I’m Dr. Amiya Prasad. I’m a Board Certified Cosmetic Surgeon and Fellowship-trained Oculoplastic Surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. I’m well known for my work with Asian double eyelid surgery for both primary and revisional surgery to correct work of other doctors.
In terms of the size of your eyes, 3 weeks is still very soon after your surgery, and you are still in the proliferative stage of wound healing. During this stage, there is a lot of fluid causing swelling, and collagen is still disorganized. Your eyelid margin will look wide, swollen, and thick during this time, making your eyes look small. It is also possible that the swelling in one eyelid is more significant than the other.
By the second month after surgery, you enter the remodelling phase of wound healing. In this stage, the collagen starts to flatten out, so swelling will gradually decrease, and your eyes will look look bigger. While full surgical healing takes about a year, you can expect the swelling to go down, and be close to your final results in about 3-6 months.
As for the crease of your eyelids going into the inner corner, you appear to have a tapered crease. The other crease you are referring to is a parallel crease. During eyelid surgery, your anatomy has its own inclination toward a tapered or parallel crease. The surgeon can try to force one of them during surgery, but often the thickness and quality of the tissue steers it towards the anatomy’s own preference, so the surgeon often has limited control over the parallel or tapered crease.
You still have some time for the healing process to continue so swelling goes down, and more accurate results are seen. If you are still unhappy with your results at the 6 month point, and they are not what you discussed with your doctor prior to surgery, talk to your surgeon. A revision for eyelid surgery cannot be done while tissue is still swollen as results won’t be accurate, but at about 6 months you are close enough to your final results that a revision can be considered. I hope you found this information helpful. Thank you for your question.

I believe crease is not able to form well on right eye due to lack of fatty tissue.
You have another fold on top of crease and it is usually due to lack of fatty tissue to begin with. It is hard to evaluate when you look upward and not looking straight so you can post another photos with two eyes looking at straight. In any case if fold is too large that can be corrected later once swelling subside.
Continue apply warm pack and and post final photos after at least 4 months from surgery date.

Dr. Andrew Choi