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  • 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!

Asian Eyelid Blepharoplasty Post-Op 7 days, I'm worried about the crease being too high

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