Thank you for your question.
You’re 39-years-old and you stated in your question that you had Asian Eyelid surgery,
the non-incisional method, approximately one year prior.
You're unhappy with the symmetry of your eyes and you submitted a photo with your question,
and you want to know what kind of surgery can be done to improve the symmetry, as well
as how to achieve an almond shape to your eyes.
Well, I can give you my opinion based on just this one photo.
I'm a Board-certified cosmetic surgeon, and I'm a Fellowship-trained oculofacial plastic
surgeon—this means my background training was first in eye surgery before I specialized
in cosmetic reconstructive surgery of the eyelids.
I've been in practice for over 20 years in Manhattan in Long Island and Asian Eyelid
surgery is one of my specialties.
What I think the issue could be with your asymmetry has to do with more than one factor
in terms of the eyelid crease.
If you look at your previous photos, before you had the surgery, chances are there was
an absence of a crease, or there may have been less definition, or there was asymmetry
to begin with.
So chances are, your doctor tried to measure a certain amount of height from the eyelid
margin to set the crease, to create more symmetric creases.
What there appears to be also, which is a reality for all of us, is asymmetry in the
orbit.
It's important to understand that the face is asymmetric, so when you look at your eye
sockets, there is a clear difference in the volume of fat or soft tissue in the left eye
compared to the right.
So a lot of times, and this requires conversation and back and forth, I would say that a lot
of times, when people are not happy with their Asian eyelid surgery, if they've had too much
fat removed well we try to restore that by adding fat.
In the case of non-incisional, that's not usually the case, where they've had fat removed.
A lot of times also, with the absence of fat or the loss of fat, it is hard to achieve
that symmetry without adding some kind of volume.
In our practice we've also had success, not only in placing fat in this sub-brow space,
under the brow area, we've also placed filler under the brow in a way to create a shape
that adds more volume.
And so instead of it being a subtractive procedure where you’re taking away something, you’re
actually adding something to create more symmetry.
I think the goal of achieving symmetry has to be tempered with the realities and limitations
of the anatomy, and the risks and benefits of the procedure that you're entertaining.
As far as almond shape to the eyes are concerned, that's usually more of a function of the outer
corner, relative to the inner corner.
So if you feel that with time or changes, the outer corner needs to be a little bit
higher, well that falls under more of a lower eyelid procedure, or a canthoplasty or a canthopexy
procedure.
It's a different surgery and there are certain traditions in Asian eyelid surgery which do
include extending the width of the eyelid by opening the outer corner and trying to
create a widening and lengthening, I should say, of the eyelid—widening from the horizontal
perspective.
So that's a separate procedure and maybe something of value to you, but I think you should meet
with your original doctor to discuss this, and if you need additional opinions, seek
out other doctors who have extensive experience with Asian Eyelid surgery, to try to narrow
down exactly what you’d like to achieve to improve your results.
Because I'm not so sure that releasing the non-incisional sutures will be necessarily
of value because, in terms of the eyelid crease, a millimeter here and there is usually tolerated,
but if your overall unhappy or dissatisfied with the appearance, then there's probably
room to entertain other options.
So I hope that was helpful and I wish you the best of luck.
Thank you for your question.