One of my eyelids have multiple creases, and I guess the other is normal. I was wondering, what is the best way to fix this? Would it be better if I used eyelid tape on the normal eye to make the crease higher, or get the eyelid with multiple creases fixed? If I try to fix the one with multiple creases, how so? I've had this for a few years now, so I don't think it'll go away naturally. It really bothers me, especially since people look at the eyes when talking to each other.
One Eyelid Has Multiple Creases and the Other Does Not? (photo)
Doctor Answers 6
Even creases for asian eyelid surgery
The eyelid anatomy in those of asian descent is unique. So are the goals of surgery. Forming a low, natural crease, remove a small amount of skin, repositioning some of the eyelid fat, may all be options to help you reach your goal.
Uneven eyelid creases
One eyelid crease is lower than the other. The left upper lid crease can be raised to match the opposite side with a unilateral blepharoplasty.
Both eyes should be treated in your case
Although the right eye is the one bothering you, the cause of the problem more likely lies in your left eye, which is slightly droopy. To maximize symmetry, both eyes should be corrected: the left eye opening muscle needs to be strengthened and a crease placed to match the opposite eye; and the right eye needs the multiple folds (probably loose fibers of the eyelid opening muscle) anchored down for a crisper fold to match the left eye.
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Reconstructing a proper eyelid crease is a common procedure in asian eyelids. This can be done with excision of small strip of skin and re-establishing the skin edge with the underlying muscle.
Your best bet is consultation with an Oculoplastics surgeon, or a facial plastic surgeon with extensive experience in Asian blepharoplasty.
Uneven crease repair
I see this in my clinic about once a week. This is not a unique issue and can be dealt with with upper eyelid surgery under local anesthesia. Essentially your lid with the multiple creases has weak and multiple attachments to underlying anatomy where as the apposing is uniform.
A physical exam is required and surgery may be required on both eyes for good symmetry. You're healing time would be about a week with 2 to 3 weeks for swelling to go down to the point they look even. Here is a link and video that may be helpful.
I hope that was helpful.
Chase Lay, MD
Proceed with great caution.
As you correctly intuit, the two eyes are different and both should be addressed surgically to give you an opportunity to have the best possible result. The right upper eyelid has multiple folds because the skin of the eyelid platform is loose. This can be addressed with a very precise anchor blepharoplasty. The left upper eyelid has a better appearing double fold but the eyelid is heavy and if this is fixed without also performing double fold surgery, it will appear as if there is no double fold on this side. A detailed consultation could address if the difference in appearance of the two sides is actually due to overaction of the frontalis on the right side due to the heavy upper eyelid on the left side (Herring's law).
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.