Thank you for your question!
You state your question with a photo submitted that you are someone who is in your late 30s,
you had natural double eyelids without surgery and that you state that approximately a year
ago the right eye drooped and you would like to fix it. And so your question is how do
you do it and should you go to someone who specializes in Asian eyelid surgery? Well
I can certainly give you my perspective and suggestions based on the photo you submitted.
I’m a board certified cosmetic surgeon and a fellowship trained oculofacial plastic and
reconstructive surgeon, practicing in Manhattan in Long Island for over 20 years and I specialize
in Asian eyelid surgery. So I can thoroughly give you an idea of what you’ve experienced,
how I would suggest considering repair and of course my opinion about specialization.
So to begin with to understand what differentiate those who have the crease and those who don’t
have the crease has to deal with the connection and the connection is an anatomic connection
between a muscle called the levator muscle and the skin. So people who are Asian who
have a crease have a more defined connection between the skin and the levator muscle. So
for someone like yourself which was naturally occurring, most likely what’s occurred is
that that connection has gone a little bit weakened and that resulted in the fold detaching
and rolling over. So if you want to make the eyes more symmetrical, you have essentially
two options one is called incisional blepharoplasty and the other is called non-incisional Asian
blepharoplasty. If you want to achieve symmetry, the most likely you are not interested in
doing anything to tighten the skin in a way so that the crease would look more sharper
and defined but in that scenario, you can benefit from a non-incisional approach.
A non-incisional approach which basically means what we are doing is we are entering
this skin at critical point along the natural crease that we want to develop and we pass
stitches in a way through the skin and engage the muscle in a way that creates a connection
and those connections lets the skin fold in and creates the effect of a crease. Now of
course with the absence of a physical exam, it’s a little bit difficult to be more definitive
but basically the distinctions I make between making the decisions between an incisional
versus a non-incisional has to do with excess skin in some cases excess fat.
So with that being said, I recommend that you meet with a doctor and I would say that
as a specialist myself that I do have a bias that we are all capable. Every doctor who
is properly trained is capable of doing a lot of things but with time, we all identify
things that we are very good at and do a lot or focus on and there are other things that
are not as good at because you haven’t put in the same amount of time. So I feel that
specialization and from my experience of 20 years in practice, my comfort and familiarity
with Asian eyelid surgery is going to be greater in someone who doesn’t do Asian eyelid surgery
with consistent frequency and focus and that’s just a matter of putting in the time. It has
nothing to do with one doctor being smarter than another. So I would say that you should
meet with doctors who do specialize in Asian eyelid surgery, learn about the approach.
In our practice when we do the surgery we do this in local anesthesia with LITE™ sedation
and there are times we will have the patient open their eyes and look at the crease and
see how it folds in just to make sure and this way our patients not only have a good
sense or how they will do after the procedure but they also don’t have to recover from
general anesthesia and of course there is no pain or discomfort during that process.
So I would recommend you to meet with doctors again doctors who specialize in Asian eyelid
surgery , learn about your options and move forward but I think that this whole concept
hopefully will make more sense now that you understand why the eyelid probably is the
way it is and what occurred about a year ago.
So I hope that was helpful, I wish you the best of luck and thank you for your question.