Inner eyelid a little shown and eyelash unbalanced after Asian blepharoplasty (picture taken on day 10) (Photo)

​hi! Can somebody help me with this? My left eyelid is a little shown and eyelash is pointed more upwards compared to my right eye. Looks like I've big and small eyes when I'm taking picture. Help! I know it's day 10 after surgery but just wanna know if this is permanent? Will it be balanced after my eyelid de swells? Anything i can do to resolve this? Thank u!

Doctor Answers 4

Eyelash and upper eyelid position will be temporarily affected during healing, but will improve with time to the final result

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Thank you for your question. You submitted a photo 10 days after undergoing Asian eyelid surgery with a concern about the inner aspect of the left upper eyelid showing more, and the eyelashes of left side turning upward more compared to the right. You are asking if this is normal and what to anticipate.

I can give you some understanding of how I discuss this kind of concern with my patients. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years and I do specialize in Asian eyelid surgery, so these types of questions come up when we discuss the procedure before the surgery.

Understand that 10 days after Asian eyelid surgery is really early in the process of healing. What we always try to differentiate when you talk about non-Asian eyelid surgery where swelling can have a different impact on the appearance of the eyelid crease. With Asian eyelid surgery, the crease is front and center because it’s the goal of surgery.

When we do Asian eyelid surgery, whether it’s with a non-incisional or incisional method, the goal is to fixate the skin in a way to create a fold in a way  you want.Preoperatively, what I routinely do is position an instrument like a Q-tip to push up the eyelid skin to show what I can likely achieve after surgery. Once we have settled upon that, I decide if it’s best achieved through an incisional or a non-incisional procedure. The decision to do an incisional procedure usually means there is some skin and/or fat to be removed. There are some blended procedures such as a limited non-incisional procedure with fat reduction, but that’s a technical topic.

That said, it is very common after 10 days to have swelling, particularly asymmetric swelling which is not specific to Asian eyelid surgery as it is common for all eyelid surgeries. As far as the orientation or direction of the eyelashes, it is not unusual that swelling can impact the shape and the appearance of the lashes. Understanding that Asian eyelid surgery is often a very significant progression from point of surgery all the way to about 6 months where swelling can shift and diminish until the final outcome is achieved. Technically, surgical healing can take up to a year, and factors such as sinus and allergies can also play a role in how the swelling changes. It is very important you discuss this concern with your doctor as no one knows the details of your surgery better than the surgeon who performed it, so they can give you some perspective on what to anticipate.

What I do in my practice on the day of the procedure are draw, plan, and show the patient what I plan to do in the exam report before we bring it to the operating room. We will even have the photos of the drawing printed out for the patient to see so they know and understand the concept of what I’m doing.

I always feel this type of communication is critical so the healing process will be predictable. Now it is one thing to understand it, and another to go through it, which is why it is important to have regular follow-ups with your doctor. In our practice, we see people after surgery at 1 week, 1 month, 3 months, and 6 months but I always tell my patients that the door is always open so they can come in whenever they have any questions and concerns. As a surgeon, I prefer them coming in as often as they need to so they feel I’m answering their questions they have which helps expedite the healing process. Meet with your doctor again to discuss these concerns, but at 10 days it is not unusual to have this type of asymmetry. I hope that was helpful, I wish you the best of luck and thank you for your question.

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New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Healing after dramatic Asian eyelid surgery

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Thank you for the photos. It is very early after your surgery and the eyelashes will relax on both sides. They may not relax perfectly evenly but I think that that should be just fine as the healing continues. Additionally, it looks as though the surgery was designed to give a dramatic look. It's going to be several weeks or months before the eyelid starts to look natural and the eyelashes start to relax. Follow up closely with your surgeon. Best of luck

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Asymmetry soon after surgery

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Your concerns about asymmetry of eyelash directions and the size of inner eyes are not uncommon in the early phase of the healing process. Please understand that healing after Asian blepharoplasty like most surgical procedures is a long process. 

Eric In Choe, MD
New York Plastic Surgeon
4.6 out of 5 stars 51 reviews

Eyelash tilting upward?

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Your post op 10 days picture shows somewhat ptotic. Your left eye had slightly more ptotic. I wonder whether you had ptosis prior to surgery and if you didn't have any ptosis before, your eyelash tilting upward will subside. It is too early to give you definite answers but if this isn't resolved after all swelling subsides lowering crease line will correct this. Keep post your photos after all swelling subsides.

Andrew Choi, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

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.