1 month post Asian Eyelid Surgery. Crease is high and deep set, making my eyes look hollow. Can massage fix this?(photos)

Thank you for your question. You have submitted several photos and state you’re 1 month after undergoing Asian eyelid surgery, and want to know how to deal with a perceived eyelid crease that’s too high and deep. You state your crease is 8 millimeters from the eyelid margin, and ask if massage can help.
I can give you some guidance on what to anticipate after undergoing Asian eyelid surgery. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Asian eyelid surgery is a significant part of my practice: I do everything from non-incisional to incisional double eyelid surgeries, and more complicated eyelid surgeries such as thyroid eye disease, eyelid ptosis, and revisional surgery.
I’m sure you discussed this with your during your consultation with your doctor prior to surgery. As someone who has practiced for a long time, I’ve found that it’s one thing to describe surgical recovery during consultation, but it’s another thing to live through it. Whether you do a non-incisional or incisional Asian eyelid surgery, it is very much the norm to have a fair amount of swelling between the eyelid crease and the margin because when you surgically create a double fold or form a crease, there has to be a connection made between the skin and the levator muscle. That connection has to be strong, stable, and withstand the healing process after the surgery when there’s swelling. When there’s swelling, there’s a limitation of how quickly the fluid can go when there’s an anchoring of the skin to the levator muscle. The larger amount of swelling temporarily causes the eyelid crease to look high.
The first month is usually the peak of this degree of swelling, and after that, it slowly gets better. Generally speaking, swelling eventually reaches a point where it becomes fairly imperceptible. When I explain surgery and swelling, regardless of the type of surgery, swelling to a certain degree can last for months, and true healing after surgery is really one year. You’re now one month out, so you’re really in the beginning of the most important process. From my experience, whether it’s Asian eyelid surgery or non-Asian eyelid surgery, most of the time, there’s a relative stability of appearance at around 6 months.
It’s very important you follow-up with your doctor. I’m sure when you chose your surgeon you had confidence in their experience and the way they perform Asian eyelid surgery with significant enough frequency. I’m sure your surgeon did mention this to you, but again it’s living through the process that is often unsettling.
I always encourage my patients to contact me at any time, but I always schedule my follow-ups closely. For a lot of my Asian eyelid surgery patients, I see them at one week, and then maybe 2-3 weeks later so it comes closer to one month, and then a month after to help coach them along. It is normal to see a progressive trend of the resolution of swelling. By 3 months or so, even though there’s some swelling, most people are reasonably comfortable.A s far as people going back to work and doing their normal activities, usually after one month it’s not too bad and doesn’t draw much attention.
I recommend you contact your doctor and maintain close communication. Your doctor who performed the surgery knows your anatomy very well, knows what to anticipate, and planned your surgery accordingly. Without knowing what you look like before surgery, and the details of your surgery, I would say there is nothing unusual about having this degree of swelling at this time. As far as expediting the fluid regress or to reduce the fluid, I think it’s not necessary to do warm compresses. I always encourage my patients to just walk, talk, and move. Sometimes I tell them to just look up and down, and move the eyelid a little more. Sometimes, people squint so they don’t open their eyes very strongly, so I have them just look up periodically to make sure they get the full range of motion of the muscle, as well as some activity to encourage fluid absorption.I hope that was helpful, I wish you the best of luck, and thank you for your question.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.

Significant swelling is normal and to be expected after Asian eyelid surgery, especially if an incisional technique was used.  Once the initial swelling resolves in 1-3 months the crease (if properly created during surgery) should become better defined.

One month is still too early and the swelling will continue to subside and the crease will decrease in size.   It should look more natural in 2-3 months.  Massage will help with the appearance of the scar but it typically won't change the crease too much.  Be patient and keep following up with your surgeon.  Best of luck!Goretti H. Taghva MD