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When Revision Should be Considered for Double Eyelid Blepharoplasty

Asian double eyelid blepharoplasty is very popular all over the world. Approximately 50% of people of Asian-descent are born with a defined eyelid crease, also known as a double eyelid fold. People who want to have a double eyelid fold do so because they want their eyes to appear more open, and brighter..

Surprisingly, a significant proportion of people who have Asian eyelid surgery become extremely concerned about how their eyelids look shortly after the procedure, so they inquire about revision surgery. I’ll talk about how I help people who come to us after having surgery elsewhere and want revision surgery.

Asian female patient before and after double eyelid blepharoplasty revision performed by Dr. Amiya Prasad
Before and after double eyelid blepharoplasty revision on Asian female patient

As an eyelid specialist, I have devoted a significant portion of my time to procedures for Asian eyes. I routinely perform both incisional, and non-incisional Asian double eyelid blepharoplasty, as well as epicanthoplasty. In addition, I perform revision Asian double eyelid procedures to correct surgery previously performed by other doctors.

The Role of Swelling in Double Eyelid Blepharoplasty Recovery

Some people believe that their new double eyelid creases are too high in the first few days to weeks after Asian double eyelid surgery. This is frequently followed by requests for immediate revision surgery.

Understanding the stages of healing can help you understand why revision surgery is not recommended in the first few weeks after surgery. Furthermore, certain aspects of Asian eyelid surgery can result in prolonged swelling between the eyelid crease, and the eyelid margin for a longer period of time than non-Asian eyelid surgery. Swelling is caused by inflammation and circulation.

korean double eyelid surgery before and 2 weeks after recovery photo
Double eyelid blepharoplasty recovery after 1 week and 2 weeks of young female patient
Temporary swelling can make the crease appear much higher than it is. Whether the surgery is non-incisional or incisional, a particularly important part of the surgery is the placement of sutures to connect the skin to the levator muscle, which lifts the eyelid. Small incisions are made into the skin where sutures are placed to make this connection, resulting in the formation of a crease. A small amount of skin and fat are removed during incisional surgery. Sutures are used to close the skin, which engages the levator muscle to form a crease. In general, I’ve noticed less swelling for a shorter period of time.

When to Consider Asian Blepharoplasty Revision

The 6-month mark after eyelid surgery is when the eyelid appearance is more stable, with minimal swelling, but swelling can last for a year or longer in some cases. If a revision procedure is required, this is the time to consider it.
Asian double eyelid blepharoplasty healing/recovery after 1 year of male patient
Asian blepharoplasty healing after 1 year of male patient

Many people who inquire about revision surgery after Asian eyelid surgery reach hasty conclusions. Swelling gives the impression that the eyelid crease is too high, which is a very common occurrence. With this knowledge, what is an appropriate situation for surgical revision? The key principle of double eyelid surgery is to create a crease by connecting the muscle that lifts the eyelid, known as the levator muscle, to the eyelid skin.

If the crease is not well formed, a surgical revision can be considered. In many situations, if the crease does not develop properly after incisional surgery, I will perform non-incisional blepharoplasty to connect the levator muscle to the skin without having to reopen the eyelid as was done in the original surgery.

Asian Eyelid Surgery Before and After

Asian eyelid surgery before and after results of young male patient
before and after double eyelid surgery male

View Double Eyelid Surgery Before and After Gallery

Possible Double Eyelid Surgery Complications

An issue which can occur with double eyelid blepharoplasty is that the eyelid incision is too long and extends beyond where a crease would appear naturally. In surgery involving the removal of eyelid skin and fat, it is possible that too much skin or fat is removed. In cases where too much skin is removed, skin grafting would be necessary. If too much fat is removed making the upper eyelids to hollow, this can be addressed oftentimes with precise placement of injectable cosmetic filler.
upper eyelid hollows improved with filler before and after
upper eyelid hollows improved with dermal filler before and after

Advantages of Local Anesthesia and LITE IV Sedation

As with primary surgery, I perform revision eyelid surgery under local anesthesia and LITE IV sedation rather than general anesthesia, which allows the patient to recover faster, and more comfortably.

asian eyelid surgery recovery after 10 days
asian eyelid surgery recovery

Conclusion

After having double eyelid surgery, whether incisional or non-incisional, the crease appearing too high in the early stages of healing is normal. It is critical to communicate with your doctor and to see him or her for scheduled post-operative visits. If revision surgery is recommended 6 months or later after primary surgery, make sure you understand what will be done and how you will recover.

Double Eyelid Surgery in NYC and Long Island, New York

Dr Amiya Prasad is a Board-certified cosmetic surgeon, and Fellowship-trained oculofacial plastic & reconstructive surgeon. He’s been in practice in Manhattan, and Long Island for over 25 years. To schedule an appointment fill-up the form below or call our offices at (212) 265-8877 for Manhattan, New York City; (516) 742-4636 Garden City, Long Island; or (703) 356-1336 for Vienna, Virginia.

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