Excess Fold of Skin Left After Asian Double Eyelid Surgery?

Good morning hyannis,

It's very hard to say without photos or a physical exam but over all I'd say it's early post op.  Wait a few more weeks and see.  I will say that if the surgeon is someone who only occasionally performs Asian eyelid surgery they may have been conservative with the skin removal and this is not all bad.  My surgical practice is large majority Asian eyelid surgery and fine tuning the position of the crease while removing enough excess skin is a challenge. While I am aggressive enough with skin removal I tell all my patients you have a 1 to 2% chance of needing a small amount of skin out or some touch up after surgery.  This is because you can always do a bit more if something was under corrected, it's very difficult to fix something that has been over resected.  Just be patient.  Follow up with your surgeon.

 

Best of luck

Chase Lay, MD

 

After Asian eyelid surgery, you will need to wait at least six weeks to determine whether there is still excess skin on your upper eyelids.  Right after surgery, there will be some swelling which stretches the skin.  After the swelling goes away, the skin which has been stretched will need some time to shrink back.  Therefore, I recommend waiting until six weeks after your surgery before determining whether there is still excess skin.

It is much too soon to discuss revisionary surgery. You need to wait about 6 to 12 weeks to see how the lids look once the swelling is gone. I strongly urge you to return to your plastic surgeon and allow them to advise you directly,

Another vote for waiting for swelling and healing to occur.  You bring up an interesting point.  Without knowing your age a discussion of a browlift is appropriate and necessary in certain individuals.  A upper eyelid surgery alone can do more harm in some patients who require a browlift to correct significant brow ptosis.  It is a big mistake to remove to much of the skin of the upper eyelid.  This skin is irreplaceable and appearance of the thick brow skin that has dropped to just above the lid skin surgically removed eyelid skin can create problems.  This is not only aesthetic because the thin skin of the eyelid sutured to the thick skin of the brow creates a harsh look which is difficult to correct.  Even worse this may create lagopthalmos (inability to close the eyelids).  Although you may be able to close your eyes voluntarily with force, asleep the lids will not fully close causing a disturbing appearance to others.  Typically the eye is protected due to a dolls eye phenomenon but it can cause drying and irritation.  Just a word of precaution.  Overall, you should do fine and time should help with any concerns. 

At two weeks or so, the excess skin you are noticing is likely related to post-operative swelling. Swelling should settle down within three months. If the issue persists at that point, then evaluation for possible revision is reasonable. But at two weeks it is too early.

Time is your best friend here. Wait for a few weeks till all the  swelling is gone to determine any revision is needed. Also warm compresses and gentle massge will help to dissipate the swelling. Good luck.

2 1/2 weeks is a little early to judge the results after Asian Double Eyelid Blepharoplasty. Swelling and inflammation could cause the extra fold that you are noticing by the new eyelid crease. I would definitely advise you to wait. You don't want to do anything right now when there is swelling.
Because if you do something right now, when the swelling dissipates, your results will be different. Also at this stage your eyes have different swelling and if you try to do something symmetrical right now it will be asymmetrical when the swelling goes down. I would wait at least 3-6 months before contemplating a revision. Don't worry, things will look better for you over time.

Two weeks is too early to evaluate the results of your upper eyelid surgery. One must wait several weeks, realistically months, to appreciate the final results from double eyelid surgery in Asian patients. Also, it is better for an eyelid plastic surgeon to remove too little skin, rather than too much skin. Supplemental skin may always be removed from the upper eyelids at a later time, once all healing is complete. Best of luck.

2 and 1/2 weeks is still too early to tell if enough skin was removed. There is likely still some swelling. Is there still a double fold when your eyes are open? Perhaps what you're seeing is just the incision which may look like excess skin until it flattens out.
I would wait at least 3 months before re-evaluating whether more skin needs to be removed. It's always better to take too little skin, than too much!

Thank you for your question. I ‘ve performed Asian eyelid surgery (as well as revision surgery) for than 15 years in New York City. Although you will probably benefit most by discussing your concerns with the operating surgeon I can address your question. Swelling after eyelid surgery is normal and 2.5 weeks is early in the postoperative period. Swelling can be variable and can last for up to a year.