Asian Eyelid Surgery – Why Location of Incision is Not the Same as Final Crease Position

A lady is 3 weeks post-op from Asian double eyelid surgery, and notices the incision lines in her upper eyelids are a little different from each other. She noticed from the first day after her operation that the stitches in both eyes didn’t match. She knows that swelling still needs to subside before the results are seen, but she wants to know if her eyelids will eventually look even.

New York Oculoplastic surgeon Amiya Prasad, MD reviews her images and concerns in this video, explaining how slight differences in the operation of each eyelid, and also in healing can make eyelids appear they are not matching during recovery, but when done right, do even out eventually:

1:12 – Dr. Prasad’s background training and experience in Asian double eyelid surgery
2:01 – How an eyelid crease is created with a connection between the skin, and the muscle that lifts the eyelid called the levator muscle
2:40 – How a natural connection is made with people born with an eyelid crease, and how it is created with both the incisional and non-incisional method of Asian eyelid surgery.
3:00 – How when skin is removed in eyelid surgery, there may be a difference of amount removed in each eye, and also differences in the anchoring of the eyelid and its subsequent swelling
3:25 – How the crease placement by incision does not necessarily correspond with final crease of the eyelid, in Asian and non-Asian upper eyelid surgery
4:18 – How there is variability in both eyelids during surgery, with the first month after surgery showing the most distance between the eyelid crease and the eyelid margin at the eyelashes, but will come down after swelling subsides
4:59 – How the incision was done differently in each eyelid to optimize the final results of the surgery
5:39 – How the exact placement of the incision will be less important with time as the proper eyelid crease forms with healing
6:07 – How the wound healing process of surgery is a little slow, and consists of four stages: hemostatic, inflammatory, proliferative, and remodeling, so Dr. Prasad does take after pictures at about 6 months taking this into account
6:45 – How the first month after surgery has the most variability and shifting of swelling
7:10 – How Dr. Prasad sees patients of Asian eyelid surgery one week after surgery to remove stitches, and every month to guide them through the recovery process
7:41 – How she should follow up with her doctor for concerns, but will have to wait to heal before making further decisions about her eyelids

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