Is Asian eyelid surgery revision possible to obtain the parallel eyelid crease with my eyes? (photos)

Question

In the summer of 2011, I got eyelid surgery done in Korea. I didn't have a full, single incision done; I believe I underwent a surgery where they made several small incisions? There was little to no scarring. Recently one of my creases became undone, so I'm looking into getting my eyes done again. I've posted what my eyes looked like in 2016 (pic with the black borders), what they look like now (pic with uneven eyes), and what I'm hoping to obtain (collage pics).

Charles S. Lee, MD, FACS · Answer

The fold shape is limited by the anatomy of the eye socket. However, the larger you make the crease, the more parallel your fold will be. Your eyes, in my opinion, would do better with a tapered fold, but an in person consultation will give you the most information on how parallel a fold you can get. (one of the photos you liked is my patient from my website:))

Johnson C. Lee, MD · Answer

Thank you for your photos. It sounds and looks like you received at DST double eyelid procedure which uses sutures to create the fold. The fold is not permanent as the suture eventually weakens and can break with time which has likely happened to you. An incisional technique will be permanent. A parallel crease can be created depending on your anatomy however it is best to have an office visit where the parallel and tapered crease can be demonstrated on you. The tapered crease may be more appropriate and look more natural and beautiful for the shape of your eyes. Hope this helps!
Johnson C. Lee, MD
Board-Certified Plastic Surgeon

David Kahng, MD · Answer

hi,
after reviewing your pictures, it is important to know what technique was done originally. if a full incision was made, then it is not possible to convert you to the parallel double fold look.  if suture tech or minimal incision used then possible.  it is best to be seen in person to be evaluated.....or post a photo of your whole face to see your facial balance to see if an outfield is recommended.  hope this helps.
Dr. David kahng

David Cheung, MBChB, Bsc(Hons), FRCOphth · Answer

Hi P1nk444, Greetings from the UK. It sounds like you underwent a DST type procedure which is the most common technique and it sounds like some of your sutures detached off which unfortunately is pretty common compared with an incisional technique. Yes of course you can undergo revisional surgery and alter skin crease configuration. It depends very much on what you want doing, your attitude to surgical risk, skin availability, etc, etc. 
Options: 
Do nothing- Always an option - Least risk!
Conservative options: e.g left upper lid tape- similarly low risk. 
Left revisional surgery only (a repeat DST type technique or an incisional technique)
Bilateral surgery. ( If you're happy with the right upper lid as it currently is- then most surgeons would perform left upper lid surgery to match it with your right.)
Ideally you should see an Oculoplastic surgeon with experience in revisional Oriental eyelid surgery as this sort of surgery can be fairly complex requiring much patient preoperative counselling to discuss what they want to achieve and the risks of revisional surgery

Best Wishes and good luck

David

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