Thank you for your question.
You submitted two photos and you’re stating in your question that you’ve been using
eyelid tape to create an eyelid crease for approximately two years.
And you’ve been thinking about a year and a half of having eyelid surgery performed.
And you are anticipating travelling to Korea to have it done and you’re asking would
a partial incision approach be beneficial or full incision.
And in the last part of your question, you’re asking if it would hurt.
Well, I can certainly give you my perspective in your situation.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon.
Asian eyelid surgery has been a practice of mine for over 20 years, practicing in Manhattan
and Long Island.
So I can certainly give you some ideas of what I do for patients like yourself when
you come for consultation.
To begin with, we start by simply making some definitions as to what comprises eyelid crease
surgery.
When you use something like eyelid tape, you’re usually placing it in a way so that the fold
kind of and the crease follows the natural zone of what would have occurred if nature
created this connection.
To understand it better, the eyelid crease is formed when a part of the muscle called
that levator muscle, a muscle that lifts your eyelid, has some fibers that go into the skin
that defines the eyelid crease.
When you’re putting the eyelid tape on top of your eyelid, you’re actually pushing
the skin inward to help create a similar effect.
Now that being said, the approach that I like to do is depending on basically a couple of
questions.
Is there a presence of extra skin?
Is there a presence of fat that could impede the effect of creating a crease.
If the answer to both of those questions are “no”, then I generally recommend a non-incisional
approach.
Basically what I’m doing is making little openings in the skin to pass a stitch in a
way that connects the levator muscle to the skin.
Now if there is a certain amount of extra skin, then a small amount of skin is appropriate
to remove but it’s actually more a rule than the exception that for younger people
who don’t have a lot of skin and if don’t have fat that’s getting in the way, I perform
a non-incisional method.
There is a partial incisional method and there are more than a few ways to create an eyelid
crease but in the end, you’re actually measuring, placing marks in an area where you anticipate
what you want to make sure there is anchoring of the skin and then perform the procedure
appropriately.
Now in terms of travelling into an area to have surgery, some of the people come from
all over the world for treatment related to eyelid surgery, face lifting surgery, hair
loss treatment.
I certainly understand the desire to travel somewhere to get the best procedure possible.
My only concern is if you are travelling outside of your immediate area is whether or not you
plan to going to Korea for anytime within the first 6 months to a year for follow up.
The reason is as follows.
When patients come outside of this area, we have patients who come here from South Africa
for a revision eyelid surgery and from China, form Europe, from all over the world.
I always try to help them understand that there is a potential necessity to come back
to New York.
Now being located in New York City, it’s actually not unusual for people from anywhere
from the United States as well as outside United States to end up in New York City.
There is a lot of reasons to come here.
So a lot of times it’s folded into something where they would be going in anywhere or it’s
an excuse to come visit New York.
Now with that being said, people have a procedure done abroad, the question of satisfaction
of the procedure with the potential for revision as well as potential for complication has
to be addressed.
So when you ask those questions before travelling, then at least you have a plan in mind.
There is no doubt that a place like Korea, Asian eyelid surgery is going to be performed
with significant high levels of confidence but even with those situations, there are
people who we’ve seen who needed some type of management or revision.
No matter how much you do of anything, the fields of plastic or cosmetic surgery, revision
surgeries and complications always are something you’ll need to be ready for.
So with that understanding, I think you should have some consultations to get an understanding
whether or not there is extra skin, whether or not there is fat and what the options would
be in those scenarios as well.
The absence of performing a physical exam, that’s not a question that can be answered
without really examining the way the eyelid behaves and so that’s why I recommend consultation.
So I hope that was helpful, I wish you the best of luck and thank you for your question!