Triple Eyelids After Asian Double Eyelid Surgery? Normal To Use Dissolvable Sutures?

Three weeks after eyelid surgery (full incisional, skin and fat removed, both eyes) I have a triple eyelid in one eye. In addition, both incisions are uneven. I asked the doctor why there is a triple crease and she said it was because there was less fat in that eye. Now, she is offering to try to reduce the triple crease by placing dissolvable suture "from the desired eyelid crease to the eyebrow" with a small 1 cm incision on the eyelid. Is this normal? What is she doing? She won't clarify.

Doctor Answers 2

Hmmm. I think a second opinion might be reasonable.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Perhaps you have not accurately summarized what your surgeon actually told you.  However it is improbable that placing a dissolvable suture will address the triple fold.  It is not appropriate to suture the upper eyelid crease to the eye brow, even temporarily.  It is accurate that removing fat in an Asian eyelid can cause unexpected adhesions between the eyelid skin and the levator accounting for the unexpected triple fold.  This is the case that the best way to get out of trouble is to stay out of trouble.  For these reasons, I do not recommend doubling down with this surgeon.  If you were my patient, I generally advise waiting at least 6 months but there are circumstances where earlier intervention is appropriate.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Photos would be helpful

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Asian blepharoplasty can be complex and the anatomy needs to be understood. Volume loss can certainly lead to overlying skin deflation and possibility of multiple crease formation. These days, our goal is most often to preserve volume, however in the Asian eyelid, sometimes there is profound herniation of fat that requires fat removal.

I would not jump in to have surgery again so soon. I would recommend waiting at least three months, and ideally even longer to allow all the swelling and scarring to soften to figure out the true post operative result.

Then obtain a second opinion with an ASOPRS trained oculoplastics surgeon that has experience with Asian eyelids. You can find one near you on ASOPRS dot org


Good luck

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 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.