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A woman had upper and lower blepharoplasty, but she is unhappy with the results. Her eyelids are swelling and she believes that her upper eyelids are too high. She asks if it is possible to lower her eyelid crease. Dr. Amiya Prasad, an oculofacial cosmetic surgeon, explains that the Asian eyelid crease is a few millimeters lower than a Caucasian crease. One of the things that get people very nervous after Asian eyelid surgery is swelling that causes an artificial widening of the crease, but this is normal. Eyelid surgery can take several months even up to a year to heal. Generally, people start to notice an appreciable difference at the first week, about one month and three months. Unfortunately, there are times that the crease can be artificially too high especially if fat was removed or there's a hollowing process. Dr. Prasad explains that the Asian eyelid surgery is a procedure to fix and place a crease when someone doesn't have an eyelid crease or has a single eyelid or a monolid. To determine what type of eyelid surgery he should do, he looks if the patient has excess skin. This is a decision-making process whether to do an excisional procedure where a strip of skin is removed or a non-incisional procedure where he makes openings in the skin and anchor the skin to the levator muscle. The levator muscle is responsible for lifting the eyelid and creating the crease. Some people will also use an artificial technique where they'll use tape to create this artificial crease and it tends to work for most people but eventually some people will get frustrated with the continuous application of this tape. Another part of Asian eyelid surgery is determining if there is fat in the eyelid. The fat is factor in making it difficult to have a proper crease. With all those factors involved, Dr. Prasad makes a decision whether or not to remove skin and how much fat to remove at the time or surgery. The common thing between the two procedures is creating adhesion or connection between the eyelid skin and the levator muscle. At this point, Dr. Prasad suggests waiting and allowing the swelling to go down. No one wants to intervene in a situation where the tissues are swelling because accurate surgery can't be done when things are swollen. There may be exceptions to rule but in general, if there is no evidence of infection or unusual inflammation, then there is no reason to open the tissue this early of the healing phase. Dr. Prasad usually waits until there is little to no swelling to do a revision so that he can minimize the amount of scar formation. For more information, visit our website: http://prasadcosmeticsurgery.com/pras...