Why Temporary Swelling Concentrates in the Upper Eyelids after Asian Double Eyelid Surgery

Описание: A woman is 7 days after her Asian eyelid blepharoplasty, or double eyelid surgery. She is worried about her crease being too high and looking unnatural. She wants to know if this is normal and asks what she can do to address this problem.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon for 20 years, does a lot of Asian eyelid surgery, written about it and is well-versed with the different methods and techniques. One of the things that he always discusses with his patients is that the initial swelling after eyelid surgery typically makes the crease look very high. The space between the eyelid and the crease called the pretarsal area can swell tremendously. But there is variability - some people swell more than others.

Whether it's non-incisional or incisional, the very nature of Asian eyelid surgery is the suturing of the skin to the levator muscle. The levator muscle is responsible for lifting the eyelid. It almost acts like a tourniquet to cause swelling to stay in a very limited space and expand. When it expands, it makes the crease look high. The patient should anticipate that after the 7 days have passed, every week that swelling will change and that is true eyelid surgery healing. Even though the patient can have functional healing within a week, true healing is still within 6 months to a year. It takes a lot of time to really understand what the final result will be.

Dr. Prasad doesn't have the benefit of the pre-operative photo so he cannot predict if the skin will fold over. If this woman made her decision based on finding a surgeon who has a lot of experience with Asian eyelid surgery, she can be confident that the doctor anticipated that in order to create a crease, and a certain amount of overlap was necessary to create a natural double fold. There is an art to doing this that's adjusted depending on the patient's skin type, thickness, age, and degree of fat volume. There are many factors that are taken into consideration that certainly makes Asian eyelid surgery a challenge. Most likely, this woman is 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 sink in place and be more in position. When Dr. Prasad does Asian eyelid surgery or surgeries such as ptosis surgery, he will sometimes allow the patients to wake up a little bit so he can see them open their eyes and see how things look. Typically, by doing the measurements and planning ahead, he can consistently get a nice result.

Dr. Prasad advises this woman to continue communicating with her doctor and allow the time to pass. She is not going to be able to do anything interventional anytime soon without disrupting the natural healing process. The communication with her doctor will help her feel better about her anticipated recovery time.

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