Lowering and reconstructing the eyelid crease - Would the edited picture (#2) be a reasonable & possible outcome? (Photos)

It would be very difficult to tell how much your upper eyelid fold could be lowered without in person consultation. It is unlikely that fat grafts will be needed in that procedure, but it can not be excluded without in person evaluation. Consultation with a board certified plastic or oculoplastic surgeon, is recommended. Good luck.

Grafted fat struggles to survive and is associated with significant scaring. It can be necessary if the prior eyelid surgery was overly aggressive. In my series, less than 3 percent of cases require grafted fat. The reality is that it is possible to reconstruct the fold using adjacent eyelid fat in the vast majority of cases. Generally in eyelids with prior unsatisfactory double fold surgery, the prior surgeon has left the septum and the anterior orbital fat intact. That creates the opportunity to lower the upper eyelid fold, control the volume of skin and orbicularis in the eyelid platform and lower the upper eyelid crease using the living tissue in your eyelid. The challenge for you is that no surgeon in your area does this type of work. There is no substitute for a detailed, in person examination.