Asian Eyelid Blepharoplasty Post-Op 7 days, I'm worried about the crease being too high
and unnatural
The surgeon told me he placed the crease at 9mm, took off 5mm of skin and left 15mm of
skin between the eyebrow and the crease.
He also said the final result would look like the third picture.
However, it seems that the crease is halfway between my eyebrow and eyelashes.
Also, my eyelids are gauging inwards and there is absolutely no drooping of the skin over
the crease.
I am worried about whether the crease is too high and whether there will be enough skin
left to droop over the crease.
Thank you for your question!
You submitted some photos and you stated in your question that it is about 7 days after
your eyelid surgery.
You also gave some details about the 9 mm height and the amount of skin that was removed
as well as the amount of skin that's between the brow and the crease.
So you have a lot of very good information.
I'm glad that you are able to discuss with your surgeon.
And your concern is that the crease is too high and there may be not enough skin to fold
over.
So let's now explore this a little bit.
First, let's start first about what your expectations were after your surgery.
It's routine in my practice, as a cosmetic oculofacial plastic surgeon for 20 years,
I do a lot of Asian eyelid surgery, I've written about it and I'm definitely familiar with
the different methods and techniques.
But one of the things that I always discuss with my patients and there's a good chance
that your surgeon discussed with you was that the initial swelling after eyelid surgery
typically makes the crease look very high.
Now of course, there is variability.
Some people swell more than others.
But to understand that the space between the eyelid and the crease called the pretarsal
area, this area can swell tremendously.
You see the very nature of this type of surgery is there is a suturing whether it's non-incisional
or incisional to the skin to the levator skin or the muscle that sounds like the world elevator
but without the letter "e", the levator muscle, the muscle that lifts the eyelid.
What essentially it does is it almost acts like a tourniquet in a way to cause to swelling
to stay in a very limited space and expand and when it expands, it makes the crease look
high.
So anticipate that after the 7 days has passed, every week, that swelling will change.
And that true eyelid surgery healing, even though you can have functional healing within
a week then go back to work, is still 6 months to a year.
And so understanding that, appreciate that it takes a lot of time to really understand
what your final result will be.
Now as far as predicting whether the skin will fold over, understanding that we don't
have the benefit of the preoperative photo and also understanding that if you make your
decision based on finding a surgeon who has a lot of experience with Asian eyelid surgery,
you can be confident that the doctor anticipated that in order to create a crease that a certain
amount overlap to create a natural double fold would be necessary.
There is an art to doing this.
This art is also adjusted depending on the patient's skin type, thickness, the age, the
degree of fat volume, there are many factors that are taken into consideration that certainly
makes Asian eyelid surgery a challenge.
With that being understood, it is not most likely, you're not going to get a prediction
of the overlap until the swelling comes down.
It's seems intuitive that as the swelling goes down, the skin that would likely overlap
would kind of sink in place and be more in position.
When we do our Asian eyelid surgery or surgeries such as ptosis surgery, we will sometimes
allow the patients to wake up a little bit so we can see them open their eyes and we
can see how things look.
But typically, by doing the measurements and planning ahead, we can consistently get a
nice result.
So I would advise that you continue communicating with your doctor and allow the time to pass.
You are not going to be able to do anything interventional anytime soon without disrupting
the natural healing process.
And of course, the communication with your doctor will help you feel better about your
anticipated recovery time.
So I wish you the best of luck, I hope that was helpful and thank you for your question!