Thank you for your question.
You submitted your question with a photo and you state that you are now 3 months out after
undergoing Asian eyelid surgery.
And you are stating that the eyes look different enough that your doctor agrees with you.
You feel like the swelling has resolved and that you are planning to undergo revision
procedure in one month and I think you are concerned about the complications and maybe
having a greater asymmetry after the procedure.
So you’re looking for some guidance as to the course of action to take.
Well, I can certainly share with you my discussions with patients who are considering enhancement
of the surgery whether or not Asian or non-Asian eyelid 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.
I perform all types of Asian eyelid surgery especially when you talk about the upper eyelids
which includes incisional where skin is removed and non-incisional which is done with sutures
as well as all types of non-Asian eyelid surgery as well as complications and revisions.
So certainly, this is a discussion that we have routinely regardless of outcome.
I think that one of the things that we always keep mindful of when we are trying to make
a decision like this is what did you look preoperatively, how do you look postoperatively
and is the feasibility of getting the outcome that you want is of relatively low risk.
And this is a question that you and your doctor have to discuss.
In our field, it is often stated by many of my colleagues that the enemy of a great result
or a good result is a perfect result.
And there is in fact certainly a point of diminishing return when you try to keep going
after an ideal and a perfection.
I always explain to our patients that normally in life, there are certain levels of natural
asymmetry.
I say that we are beautifully imperfect and that no one has a perfectly symmetric face.
And when it comes to Asian eyelid surgery, certainly, it’s important to appreciate
the degree of difference that you want to achieve.
When I look at your photos, for me, the right upper lid area, there still is a little bit
of swelling and it may not be that significant but it might be relevant in terms of your
planning.
I recognize that in the left upper eyelid, the crease just kind of fades out and go away
from the inner part of the eye and so it’s not as deep.
So I would suspect that an enhancement procedure, if this were a non-incisional Asian eyelid
surgery would be relatively straightforward where there would be simply an application
of local anesthetic, the placement of the anchoring suture and then completion of the
surgery which can probably not take very long.
I would categorize that as relatively low risk.
I think this is a discussion for you and your doctor.
I think that any doctor who performs any surgery with any consistency is going to be familiar
with the need for enhancement.
One of our more famous colleagues in our speciality said that any surgeon who claims never to
do enhancements is either lying or just doesn't do surgery.
So it’s part of the plastic nature of cosmetic surgery is that we are dealing with some variability
of the soft tissue where we are trying to do things as predictable as possible.
Sometimes the eye socket anatomy is not going to be as cooperative.
Sometimes the skin doesn't cooperate with your intended plan.
Sometimes it doesn't heal as predicted.
These are just part of the realities of what we do.
So I think that it’s important for you to have this discussion.
And again, the ideal situation where an enhancement can really make an impact is when the procedure
is going to be not that extensive and with a high likelihood of having the desired outcome.
So discuss this with your doctor and hopefully you will be able to come to terms with what
is the best course of action to take moving forward.
So I hope that was helpful, I wish you the best of luck and thank you for your question.