Can a small to medium crease for Asian eyelid surgery be so swollen that it temporarily looks like a very large crease?

Question

Biting the bullet here and posting some pictures, as I had wanted to stay anonymous and not post any pictures, but I know it's very helpful for me when I can see photos of RealSelf Members, plus I hope I'll get more answers to my questions and concerns from doctors and other members by posting some pictures. Is it possible for a small/medium eyelid crease to temporarily look like a very large crease? Will it decrease in size over time by at least 50%? When should I be concerned if it doesn't?

Goretti Ho Taghva, MD, FACS · Answer

Thank you for your question and your photos. It's normal after eyelid surgery for your eyelids to swell and for the crease to appear much wider than you initially discussed with your surgeon.  Eyelid skin is very thin and it swells up easily.  It usually takes anywhere from 2-6 weeks for the swelling to go down.  The crease can sometimes shrink to half its size once the swelling subsides.  I would continue icepacks, try taking bromelain supplement, decrease salt intake and sleep with your head slightly elevated.  It will take ~3-6 months for you to see the final result.  Don't worry and best wishes!

George Volpe, MD · Answer

In the first couple of weeks it is possible for swelling to make the crease under expected. If you notice this on both sides and do not suspect swelling is the cause, although there is some changes with time, the changes may not be as significant as you wish. Discuss your concerns with your plastic surgeon. He or she may after several weeks wish that you massage or could discuss with you other possible modalities for improving the double crease.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your concerns and posting your photographs. You are still at the early part of the healing process. Your eyelids look normal at this point. Your swelling, crease and overall appearance will greatly improve over several months. You do not need to be anxious, because you will probably be very happy with your final results. Good luck.

Costas Papageorgiou, MD, FACS · Answer

Swelling of the eyelid soft tissues can affect the dynamics of the muscles and lower the eyelid. As a result the eyelid platform appears longer and the crease bigger. As the swelling subsides over the next few weeks there will be a gradual improvement of the crease.

Amiya Prasad, MD - Account Suspended · Answer

Thank you for your question. You’d like to know if a small to medium eyelid crease can look like a very large crease temporarily after surgery.Just a bit of information about myself — I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. Asian eyelid surgery is an area I specialize in, so I can certainly give you my perspective on this.Regardless of whether it’s an incisional or non-incisional approach, there’s always a specific connection that has to be made between the skin and the levator muscle (the muscle responsible for lifting the eyelid), and this requires meticulous planning in terms of ideal crease placement. This connection is made by means of sutures or stitches, and in this narrow space, fluid will collect and cause quite a bit of swelling that can remain present for weeks or months. In some cases, swelling has been known to last for up to a year.In my practice, I make sure to take the time to discuss the phases of wound healing with my patients — that the inflammatory phase to the proliferative phase, otherwise called the wound remodeling phase, can go on for a year or more. The first month is usually when the swelling is at its most, that their crease is going to look high and large, and that in some instances, the swelling of one eye can look different from the other.So, to answer your question, yes, it is absolutely possible for a small to medium crease to look like a large crease — in fact, this is usually the case, and it is rare for someone to have little swelling. When I perform this type of surgery, I’ll sometimes have the patients open their eyes just so I can see how the crease is folding in, but because of the anesthetic, there’s still going to be some swelling. This is why careful planning, measuring, and marking are crucially important.I recommend that you continue with your scheduled follow-ups with your doctor, and discuss these concerns of swelling with them, as well as any other concerns you may have. In our practice, we usually see our patients at one week, one month, three months, six months, or as often as any patient needs to come in, as it is certainly much easier to make assessments in person rather than from a distance.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Can a small to medium crease for Asian eyelid surgery be so swollen that it temporarily looks like a very large crease?

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