Chinese Height Increase Surgery

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How Swelling after Can Cause a Temporary IncreaseEyelid Height after Asian Eyelid Surgery

I Am Asian, and Had Upper and Lower Bleph.Is It Possible to Lower my Eyelid Creaseé It's been 11 days since my upper and lowerbleph and I am very unhappy with the upper eyelid result. I originally just wanted alower bleph to remove the dark circles. My recommended I also do upper eyelidsto remove the excess hooded skin (I am 43 years old, had Asian double eyelid surgery25 yrs ago). Even though there is some swelling, I believe the incision on the upper eyelidsare way too high for my Asian eyes. I've have been researching for an eyelid to have a revision. Thank you for your question!

You've submitted some photos after undergoingAsian Eyelid surgery 11 days ago. And although you acknowledgeyour question that youknow that there is some swelling that you already believe that the eyelid crease sensationis too high. So certainly you are entitled to at least have a concern. It is probablya little bit too early to start seeking advice for revision surgery. You see, Asian eyelid surgery, once you havea relative amount of experience, is the principles are relatively straightforward. Understandingthat Asian eyelid crease is a little bit lower, there has to be a fold and the position ofthat crease is typically several millimeters

lower than a Caucasian crease. Now one ofthe things that gets people very nervousthe beginning is swelling that causes an artificialwidening of the crease. You see the eyelid platform is what you're looking at and you'reinterpreting that the crease is too high. Now what generally happens is that, with time,we're talking about eyelid surgery can take several months even up to a year to go away.But generally, people start to notice an appreciable difference at the first week, about one monthand 3 months. So you can just compare those photos to get a sense of what's going on. Now there are times that the crease can beartificially too high if fat was removed or

there's a hollowing process. Buttermsof the actual crease placement and the fixation just to understand what Asian eyelid surgeryis,, is basically when someone doesn't have an eyelid crease of has single eyelid or amonolid, there is something that I look at to determine what type of eyelid surgery todo. The first thing I look at is if there's excess skin. That gives a me a decisionmakingpoint of whether or not to do an excisional procedure where a strip of skin is removedor a nonincisional procedure where we're making actual openingsthe skin and anchoringthe skin to a particular muscle called the levator muscle. And the levator muscle likethe word elevator is the muscle responsible

for lifting the eyelid and creating the creasein that way. Some people with Asian technique would make almost an artificial techniquewhere they'll actually use tape to create this artificial crease that tends to workfor most people but eventually some people will get frustrated with the continuous appliionof this tape. Now the other parts of the equation is, isthere fat and is that fat responsible for obliterating or making difficult to have aproper crease. So with those factors understood, I make a decision whether or not remove skinand how much fat to be removed at the time of surgery. But the common thing is that weare creating an adhesion or connection between

the eyelid skin and the levator muscle. SoI think at this point, you certainly can get additional opinions. But I think most peopleyou go to will say to you that you have to wait and you have to wait to allow swellingto go down because no one wants to intervenea situation where the tissue is swelling.I always I tell people who come to me with a similar situation that if I were to go inwhile the situation is swelling, I'm working with a moving target. And can't do accuratesurgery when things are very swollen. There are exceptions to the rule but as a generalbasis when there's no evidence of infection or any type of unusual inflammation, there'sno reason to gowhen the tissue is just

Anatomic Factors that Determine a NaturalLooking Eyelid Crease after Double Eyelid Surgery

Thank you for your question! You submitted a question without any photosbut you stated that you had Asian eyelid surgery done about two weeks prior and you feel alreadythat the crease is lower than you would like and that you have minimal swelling and youwant to know about the option of when is the safe time to have revision and you want toknow are there compliions related to going through the original incision. Well, I cancertainly assist you with this questionmore broad terms. I'm a board certified cosmetic surgeon anda fellowship trained oculoplastic and reconstructive

surgeon. The oculofacial surgery backgroundcomes from first specializingeye surgery before doing very advanced trainingcosmeticand reconstructive surgery of the eyelids through the American Society of OphthalmicSurgery. So you can imagine that I do a lot of work with eyelids and I have beenpracticefor over 20 yearsManhattan and Long Island and Asian eyelid surgery has been a focusof my practice bothprimary surgery and revision work. So to understand this type of situation, Ithink it's important first for you to reflect back how you came to the conclusion of whattype of surgery to have when you had your

consultation with your . To understandin broad strokes about how Asian eyelid surgery is divided, it's divided into incisionaland nonincisional and then within those two types of surgery, we make decisions aboutdoing either a parallel crease or a nasally tapered crease and essentially, with the occasionalpatient who may want an epicanthalplasty. That being said, I'll tell you how I approachthis type of proceduremy practice. It's my philosophy and it has worked outwell for me and for the people who come to me that my goal is to create an eyelid creaseas if nature has already created a crease there. It's well understood that 50% ofAsians have a crease and 50% don't but even

within that population of having a crease,there is going to be a variety and variations based on skin thickness, the genetics of characteristicspassed through a family, the amount of fullness, how deepset the eyes are. And what I usuallyconclude and I do a simple test using just a Qtip or a special eyelid crease deviceto just create the crease as if you already had it and it gives me an idea of what kindof zone I'm able to work within. I've learned overtime and I've seen from patientswho have come through referral that even though you may want to have a certain anatomy, alot of times the body just doesn't allow that type of anatomy to be created.

And so when you writeyour question thatthe crease is lower than you had wanted, understand that there is still a relatively narrow zonein which an Asian eyelid crease is typically placed. Now, just for a sake of reference,the typical crease for an Asian eyelid is anywhere from like 68 millimeters comparedto a nonAsian eyelid which is closer to 10 millimeters and that's at the central heightof the eyelid. So if you think about it, if you feel like your crease is too low, howlow can it really beé Is it more likely that you're dealing with maybe some swellingabove the crease that may look like the crease is too low. It also, from the procedure orat least the statement that you had an incision

and you're concerned about getting anotherincision, it may be that what you're dealing with is more overlap of skin than you wantand not so much the height of the crease. As a general rule of thumb, the backbone ofthe eyelid called tarsus usually is consistent with around the same height as the eyelidcrease. And so it's likely that your surgeon placed the crease at that height butdetermininghow much skin to remove, may have been more conservative to create a more natural appearance.It's very important to understand that as opposed to nonAsian surgery, you always haveto leave a certain amount of skinorder for the skin to fold over and look natural.If you take a lot of skin over aggressively,

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