Thank you for your question.
You submitted a photo showing your eyes 10 days after undergoing Asian eyelid surgery
and you’ve expressed a concern about the inner aspect of the left upper eyelid showing
more eyelid as well as the eyelashes turning upward more compared to the right.
And you are asking if this is normal and what to anticipate.
Well, I can certainly give you some understanding of how I discuss this kind of concern with
my patients.
A little bit of 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 certainly these types of questions come up when we discuss
the procedure before the surgery.
So, understanding that 10 days after Asian eyelid surgery is really early in the process
of healing.
What always try to differentiate is that 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 of the goal of a desired outcome in Asian
eyelid surgery.
Essentially, 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 that creates a fold in a way that you
want.
And so preoperatively, what I routinely do is I’ll actually position an instrument
something simple like a Q-tip to push up the eyelid skin and show what I can most likely
achieve within reason after surgery.
And once we have settled upon that, I decide if this is a situation for incisional procedure
or a non-incisional procedure.
The decision to do an incisional procedure usually means that there is some skin to be
removed as well as some fat.
There are some blended procedures such as a limited non-incisional procedure with fat
reduction but that’s a technical topic.
That being said, it is very common after 10 days to have swelling particularly also to
have an asymmetric swelling nonspecific to Asian eyelid surgery.
Pretty much, it is common for all eyelid surgeries.
And 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 and
have a continual evolution until the final outcome is achieved.
Technically, surgical healing can take up to a year and factors and variables such as
sinus and allergies can also play a role in how the swelling changes.
So, I think it is very important that you discuss this concern with your doctor.
No one knows your surgery better than the surgeon and the surgeon who performed it will
recall details about your surgery and certainly give you some perspective as to what you can
anticipate.
What I do in my practice is, I will, on the day of the procedure, do my drawing and planning
and show the patient what I am doing and this is done in the exam report before we bring
it to the operating room.
And we will even have the photos of the drawing printed out for the patient to see so that
they can actually know what I’m doing and understand conceptually what I’m doing.
So, this type of communication, I always feel is so critical so that during this process
of healing after this treatment or after this surgery will be predictable.
Now of course, it is one thing to understand it and one thing to go through it which is
why it is important to have regular follow-ups with your doctor.
In our practice, we see people at 1 week, 1 month, 3 months, 6 months but I always tell
my patients that the door is always open.
Come in whenever you have any questions and concerns.
As a surgeon, as someone who wants to examine them, I will prefer them coming in as often
as they need to so that they will feel that I’m answering the questions that they have
and that really helps expedite the healing process.
So meet with your doctor again.
Discuss these concerns but I think at 10 days, it is not unusual to have this type of asymmetry.
So I hope that was helpful, I wish you the best of luck and thank you for your question.