This was a question that I answered for someone that had a ptosis repair with persistent swelling for 4 months after the procedure. This is how I answered this question:

This is my opinion on what is likely going on. I think that the approach that was made to correct your ptosis repair has caused some contracture and tissue buildup to create a crease for you that you did not have before. That is why you are seeing more lid on the left side.  The way to correct this would be to assess where the crease is set on the good eye. Approach the revision at the same height as what you measure on the good eye, revise the ptosis repair and then close without recreating your crease.  If you do have a distinct crease on the good side, I would create the crease on the ptotic side at the same height as the good side.  The issue would then be whether the current crease will have the tendency to reform.  This can be prevented with some fat grafting through my techniques.  Although this is my opinion, I’m pretty sure this is what has happened.  You can always write me if you would like some more counsel.

If you ever want some questions answered you can always email me here.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

You can reverse Asian Blepharoplasty and double eyelid crease formation (Dr Young Bellevue, near Seattle, Washington).  You are correct that fat injections can be a part of this. But this all depends.  If there is too much skin taken, a skin graft could be needed and the cosmetic outcome could be less favorable in this situation.  Lowering the crease requires elevating the scar and then resetting the crease to a lower height, and then requires fat grafting to the area above the new crease or a tissue graft.  You need experience in this though and there is a learning curve based on my experience. Here is a video on asian blepharoplasty.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

This was a question a lady asked me after she received a double eyelid crease with her Asian Blepharoplasty procedure.  She felt that her crease was too high and she lost her ethnicity.  She also felt that her left eyelid was lower which made her left eye smaller.  She thought that there might be a ptosis in that eye.

Here is how I answered her question:

Ptosis in the eyelid is correctable and you can lower your crease after Asian Blepharoplasty.   Sometimes doing an Asian Blepharoplasty will reveal a ptosis that wasn’t as apparent before the procedure because the Asian Blepharoplasty can remove the skin that over hangs the eyelid margin that can hide a ptosis.  Ptosis surgery can be done by a doctor that does a lot of Asian double eyelid surgeries.  It just entails shortening the muscle that elevates the eyelid margin called the levator aponeurosis.  This is the same muscle that you have to work with to create the double eyelid crease in Asian Blepharoplasty.  Some choose to wait to do the double eyelid asian blepharoplasty after the ptosis surgery.  In my hands, I have confidence in getting a good result doing them at the same time.  Revision asian blepharoplasty to lower the crease is a difficult procedure.  It entails releasing the scar, and then adding fat into the area to block the readhesion of the crease and recreating the new eyelid crease. Here is a video on asian blepharoplasty.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

This eyelid weakness after Asian Double Eyelid Surgery is a very common occurance and will get better or at least should get better. Your doctor would know best what was the status during your procedure. This weakness is due to the fact that your eye muscle that opens up your eye is the same muscle that you use to create the eyelid crease.  So you need sutures that are attached to this muscle.  These sutures can place the muscle under tension and make them temporarily weak. This is really common.  The other scenario is less than desirable and can occur if there is any damage to the muscle that opens up your eye.  If this is the case you could need a more formal repair to repair that muscle.  This would require a more complicated surgery.  This is much less likely.  The other situation is when the levator or eye muscle that opens up the eye is placed under too much tension when creating the eyelid crease.  This can occur when the crease is set too high on the levator.  You can go on my blog to read about more of this and this is found on my website.  When this is the case it will take longer for the muscle to recover.  Sometimes it won’t recover and the levator needs to be released from the fixation and refixed. This situation is more rare fortunately. The hard lump will get better with time. Sometimes steroid injections can help this get resolved more quickly. Your physician can determine this as well. Here is a video of an asian eyelid surgery.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Eyelashes can be affected by asian eyelid skin. When you lack a double eyelid crease, the extra skin can lay over the eyelashes and can affect the way they are positioned.  When you do a double eyelid crease procedure, the skin can be positioned higher and this can allow the eyelashes to rise up higher.  Also there are ways to attach the levator muscle to the skin and orbicularis muscle to elevate the eyelashes to a different degree with Asian double eyelid surgery / eyelid crease formation surgery.  Sometimes this relation of the eyelashes with the eyelid is natural depending on the person’s anatomy and what they inherited. Here is a video of an asian eyelid surgery.

Thanks for reading,

Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Some doctors feel that you should repair the ptosis and then do the double eyelid surgery 6 months later. Ptosis Correction with Asian or Double Eyelid Creation can be done in stages but also all at once in my hands.  This has not been a problem for me.  After reattaching the levator to the tarsus in the best position, I then attach the levator muscle to the orbicularis muscle or skin or whatever technique you use for the double eyelid crease.  This has been okay to do for me in my hands.  I think some people stage this procedure because they feel that they will have some better control of the results.  But I think if you can do it in one procedure why not.  You can always stage a revision if the results are not as desirable.  But usually one surgery is possible to correct them both with out needing more surgery in my experience.  Here is a video of an asian eyelid surgery.

Thanks for reading,

Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington