Thank you for your question.
You submitted a single photo with your question.
And you stated in your question that you underwent Asian upper eyelid surgery about 4 weeks earlier
and that you are worried about an additional crease or fold that is pointing towards your
nose and you want to know if this is normal.
Well, certainly, I can share with you my perspective about your situation in this stage as Asian
eyelid surgery is a significant part of my practice.
In fact, patients come to us from around the world for this type of surgery both primary
or revision surgery.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
And as I said, Asian eyelid surgery is a practice focus for us and I can basically give you
an understanding that I suspect your surgeon also shared with you.
To begin with, Asian eyelid surgery in principle is about creating a connection and this is
whether it’s non-incisional or incisional.
Basically, it’s a connection between the skin and a muscle called a levator aponeurosis
or the levator palpebrae muscle.
The point is that there are stitches that are placed to make that connection and between
the eyelid and the new crease is an area where a lot of fluid can collect.
And what I see in your photo is that there is swelling and that swelling affects the
skin as I described from the margin to the crease as well as above the crease.
What is unique to a degree in Asian eyelid surgery is that this swelling can persist
for months.
It goes down slowly but it can be significant enough to affect the area and affect the appearance.
So essentially, it is something that does require time.
Now, based on this appearance, it looks like your doctor did what’s basically a nasally
tapered crease.
Why I think that’s important is that if the design was such that it’s stopped just
short of the epicanthal fold then it’s not likely that there’s that much tension that
would be pulling the eyelid skin parallel to the epicanthal fold.
You know, there are basically two types of creases when we think about designing a crease
for Asian eyelid surgery.
There’s a nasally tapered crease and there’s a parallel crease.
If this is most likely what it looks like is a nasally tapered crease, then I would
suspect this fold is more of a result of tension as well as swelling.
And as the tension and swelling diminishes and the area matures, it’s likely to be
less significant.
It’s important to understand the stages of wound healing.
And although we are very proud of helping our patients get back to work as early as
a week after surgery, it is still important to understand that the body goes through very
specific stages of healing.
And the first month is basically what’s referred to the proliferative stage.
This is a stage where there’s a lot of collagen being produced, there’s a lot of blood supply
and a lot of activity.
And when there’s a lot of activity around the eyelids, there is swelling.
So it’s understandable to be concerned but I think that you have to allow this area to
heal.
And when I say heal, I’m talking about several months.
So basically, allow at least 3-6 months.
I think that’s of course very important that you speak to your doctor about this.
But as we do in our practice, we see our patients fairly frequently particularly after Asian
eyelid surgery.
So we might, in the first few months, see a patient like yourself every month just to
monitor the process and see how the swelling is resolving and help give guidance about
how things are going and as well show the progress so that you get a better sense of
how, even though it doesn’t look like a lot of change over time, there is significant
change.
So I hope that was helpful, I wish you the best of luck and thank you for your question.