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  • How is Asian blepharoplasty performed? Possible ptosis or just swelling?

  • I read that it takes 5-7-10 days for Asian upper eyelids to look presentable. I am 12

  • days past the surgery. I am wondering whether it's ptosis or the surgeon took out too much

  • fat and unfortunately resulted in a hollow appearance? I am extremely upset and regretting

  • my decision for Asian blepharoplasty. Please let me know how long swelling will likely

  • take to subside. Does blepharoplasty involve taking out a lot of fat from the eyes? Is

  • dryness a permanent condition?

  • Thank you for your question!

  • You presented in your question a lot of the typical questions that people have after Asian

  • eyelid surgery. Certainly you've done your research and you're asking questions about

  • ptosis. This is a photo you submitted that I believe 12 days after your surgery and you're

  • asking whether too much fat was removed and whether you have ptosis. So this was something

  • that probably was discussed during your preoperative evaluation but it is certainly something that

  • can be reinforced and I'll share with you how we discuss the recovery period of Asian

  • eyelid surgery with our patients.

  • So let's start with what makes the Asian eyelid surgery recovery period a little bit longer

  • typically than for a non-asian eyelid procedure. Essentially, there is some anatomic factors

  • and some procedure that has to do with probably why an area of the eyelid we call the pretarsal

  • area. The pretarsal area is the space between the eyelid crease and the eyelashes. When

  • Asian eyelid surgery is done and this is a person who has a little bit of extra skin

  • or almost no extra skin but has fat that is actually blocking the connection between the

  • levator muscle, the muscle that lifts the eyelid like the world elevator, and the fibers

  • that we create a crease.

  • You asked about fat removal. Well, when we do Asian eyelid surgery, very often we're

  • not actually removing a lot of fat because the more fat you remove, the more relative

  • hollowing you can get but rather what we do is we look to see if the fat will get in the

  • way of the attachment we are creating surgically. What we're essentially doing is we're taking

  • the skin between the crease and the lashes and we're connecting it to the levator muscle.

  • That creates a little tight compartment. Essentially, what generally happens is there's swelling

  • and that swelling typically takes time. So when I see my patients, I usually see them

  • closely in the first few weeks after the surgery to help them feel confident that what they

  • are experiencing is normal.

  • So it is normal to have swelling from the crease to the eyelashes. In some people, that

  • swelling can last for several months and subtle degrees of swelling can make a huge difference

  • in the appearance. So a lot of times, people will feel panicked that the crease is too

  • high because the swelling of the pretarsal area causing the eyelid crease to look higher.

  • So I always explain that where you are at one week, two weeks, one month, three months

  • is going to be an evolution. If there are other factors such as sinus issues or allergies

  • or even allergy to the antibiotic ointment, these are things that can prolong the swelling

  • of the eyelids.

  • So it's very important that you communicate with your doctor and not jump to conclusions

  • about your appearance. Certainly people can look like they are hollowed out in the beginning.

  • This is an area where there's a dynamic architectural change. What I like to do, during the surgery

  • in some patients and actually for most patients, when we are doing the surgery, we actually

  • have them open their eyes to take a look of how the eyelid creases in. It kind of gives

  • a window of opportunity to identify if the eyelid crease looks the way we intend it to

  • look. If it looks good during surgery then it'll probably look good after surgery. There

  • are also exceptions and sometimes revisions are necessary, that's a part of cosmetic surgery.

  • But in your situation, I would suggest to you that you're probably early in drawing

  • in your conclusions and that you should communicate with your doctor about what your concerns

  • are. You know your doctor has your photos of you before surgery and can review with

  • you what you can anticipate. But it just seems that your concerns are consistent with the

  • typical healing process related to Asian eyelid surgery. But no one knows better exactly what

  • happened during surgery better than your surgeon. So communication is always very important.

  • I hoep that was helpful, I wish you the best of luck and thank you for your question!

How is Asian blepharoplasty performed? Possible ptosis or just swelling?

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