Why do I have a second crease and a keloid? (Photo)

The appearance and height of your creases will continue to change as your eyelids heal and the swelling resolves over the course of this year.  Symmetry will likely improve as you heal, but follow up closely with your surgeon to ensure the best results.    

Dear jaybarfiend,
Thank you for your question. Based on the photos you submitted, the scar appears to be healing within the normal limits. In reference to the second crease, are you referring to the medial (inside by the nose) aspect of your left eye?  You are absolutely correct that healing takes time and is different for everyone.  Scars can be darker or redder in those with more pigment (Asians, African Americans) and are sensitive to sunlight for up to one year.  The scar is constantly remodeling in the year following surgery and during this time, it is important to limit sun exposure. Wearing sunglasses while outside is recommended, as it is difficult to apply sunscreen to this area.  Please follow up closely with your plastic surgeon for further recommendations.
Best, 
Dr. Kahng