I Am Asian, and Had Upper and Lower Bleph.
Is It Possible to Lower my Eyelid Crease?
It's been 11 days since my upper and lower bleph and I am very unhappy with the upper
eyelid result.
I originally just wanted a lower bleph to remove the dark circles.
My doctor recommended I also do upper eyelids to remove the excess hooded skin (I am 43
years old, & had Asian double eyelid surgery 25 yrs ago).
Even though there is some swelling, I believe the incision on the upper eyelids are way
too high for my Asian eyes.
I've have been researching for an eyelid specialist to have a revision.
Thank you for your question!
You've submitted some photos after undergoing Asian Eyelid surgery 11 days ago.
And although you acknowledge in your question that you know that there is some swelling
that you already believe that the eyelid crease sensation is too high.
So certainly you are entitled to at least have a concern.
It is probably a little bit too early to start seeking advice for revision surgery.
You see, Asian eyelid surgery, once you have a relative amount of experience, is the principles
are relatively straightforward.
Understanding that Asian eyelid crease is a little bit lower, there has to be a fold
and the position of that crease is typically several millimeters lower than a Caucasian
crease.
Now one of the things that gets people very nervous in the beginning is swelling that
causes an artificial widening of the crease.
You see the eyelid platform is what you're looking at and you're interpreting that the
crease is too high.
Now what generally happens is that, with time, we're talking about eyelid surgery can take
several months even up to a year to go away.
But generally, people start to notice an appreciable difference at the first week, about one month
and 3 months.
So you can just compare those photos to get a sense of what's going on.
Now there are times that the crease can be artificially too high if fat was removed or
there's a hollowing process.
But in terms of the actual crease placement and the fixation just to understand what Asian
eyelid surgery is,, is basically when someone doesn't have an eyelid crease of has single
eyelid or a monolid, there is something that I look at to determine what type of eyelid
surgery to do.
The first thing I look at is if there's excess skin.
That gives a me a decision-making point of whether or not to do an excisional procedure
where a strip of skin is removed or a non-incisional procedure where we're making actual openings
in the skin and anchoring the skin to a particular muscle called the levator muscle.
And the levator muscle like the word elevator is the muscle responsible for lifting the
eyelid and creating the crease in that way.
Some people with Asian technique would make almost an artificial technique where they'll
actually use tape to create this artificial crease that tends to work for most people
but eventually some people will get frustrated with the continuous application of this tape.
Now the other parts of the equation is, is there fat and is that fat responsible for
obliterating or making difficult to have a proper crease.
So with those factors understood, I make a decision whether or not remove skin and how
much fat to be removed at the time of surgery.
But the common thing is that we are creating an adhesion or connection between the eyelid
skin and the levator muscle.
So I think at this point, you certainly can get additional opinions.
But I think most people you go to will say to you that you have to wait and you have
to wait to allow swelling to go down because no one wants to intervene in a situation where
the tissue is swelling.
I always I tell people who come to me with a similar situation that if I were to go in
while the situation is swelling, I'm working with a moving target.
And can't do accurate surgery when things are very swollen.
There are exceptions to the rule but as a general basis when there's no evidence of
infection or any type of unusual inflammation, there's no reason to go in when the tissue
is just so early in the healing phase.
Now there is some timing that is helpful.
Sometimes we wait until just some enough swelling is going down to and do a procedure, a revision,
not necessarily Asian eyelid surgery, but other eyelid surgery because I want to minimize
the amount of scar formation but then that is determined by case to case basis.
So I think what you really need to do is talk to your doctor.
Stay in communication with your doctor, follow-up and if you had made your decision to have
this doctor do your surgery, mostly likely that you were impressed that the doctor had
enough experience with Asian eyelid surgery and so I wouldn't say just to abandon all
hope at this point.
So I thank you for your question and I hope that was helpful.