How long should I wait for double eyelid revision?

Question:

Hi, I’m 23 years old. I just did my eyelid surgery one week ago but I realize that the crease line is not my type at all. It is a round t bridge shape. I wanted my crease, a smooth, natural, t bridge shape from low to high.  I wonder if I can do the revision surgery at second week even though I wait for three months it’s still definitely not the shape I wanted. Can I get some advice?

 

Answer from Dr Amiya Prasad :

Thank you for your question, you submitted two photos and you state in your question that you had your surgery about one week ago, the Asian eyelid surgery. And you state in your question that you’re not happy with the way the crease looks, and you want to know if it is possible to revise the increase in the second week and that you state with certainty that if you were to wait three months that you would still need a revision because you want to have a certain look to your crease. Well I could certainly give you some guidance on this concern.

I’m a board-certified cosmetic surgeon and fellowship trained ocular facial plastic and reconstructive surgeon practicing in Manhattan and Long Island for over twenty years. And Asian eyelid surgery is an area of expertise. I do both primary and revision surgery for Asian islands, non-incisional and incisional. So I can certainly give you a perspective based on how we do our procedures and the process and I think that there is probably some room to allow for the procedure to heal before you draw this conclusion.

To begin with. When I do my evaluation for a patient. I always make that first decision is whether to do a non-incisional versus an incisional and then once we’ve decided the reason for doing one or the other, on the day of surgery, I spend a lot of time with my patient in terms of planning and drawing. And the patient looks at the drawing and looks at the effect because I basically just pushed a, use a little eyelid crease device as well or Q-tip to show what they can anticipate and so that there is clear communication of what the expectation is.

Now I always prepare my patient by telling them your eyelid is going to be swollen. It is very typical, from the eyelid margin to the crease, regardless of where you place that crease to become so swollen that it looks like the crease is very high and that it looks like a shape that is undesirable.

Eyelid incision and crease definition takes time to settle and it is not a usual for the true crease, as is intended during surgery to develop over the course of several months. So I give patients that heads up and anticipation. And I am pretty certain that your surgeon probably told you the same.

I think that by looking at swollen eyelids is very difficult to state definitively that you will need revision. I certainly would advise against doing revision in the second week and it’s clearly because essentially what can we accomplish by doing some kind of surgery in the second week when the tissue is so swollen. It is never desirable for a surgeon to work on swollen tissue that can be avoided.

So I think that for now you should speak to your doctor. Ask what are things going to look like as time goes on. I am pretty confident your doctor will say that everything was planned out according to your wishes, and that essentially you have to allow time to settle out.
With my patients I always tell them that certainly there’s always a possibility that there may be a need for revision surgery. That’s the nature of cosmetic surgery. Everything is soft tissue that we’re working with, and millimeters can make a difference and there should be always room for that as an option, but timing is very important.

So I think that if you had this similar type of experience with your doctor. Where before surgery everything was measured, discussed, planned, drawn and you looked at the plan and the drawing and you saw that this was what you wanted to do, then I am confident that an experienced cosmetic surgeon who performs Asian eyelid surgery with some consistency will likely be able to deliver the type of results that you were expecting.

So I don’t think you need to just draw this conclusion or prediction that you will need absolutely revision surgery. First communicate with your doctor. Learn what is going on and what to expect review what the plan was, and as your follow-ups occur. I think you’ll see as the swelling comes down chances are you’ll get closer to what you had expected, and you may feel a little but more confident in the final outcome. But again, I would not advise revision surgery in the second week. So I hope that was helpful, I wish you the best of luck.