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.