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A young woman, aged 25, had upper eyelid surgery 2 years ago. She wasn't happy with the results but waited a year after for her eyelid to fully heal. She visited her doctor again and he said he could take some extra skin away but warned her about the increased risk of scarring or pigmentation. Now she is hoping for an opinion about whether she should do it or not. On an article that Dr. Amiya Prasad wrote called ethnic considerations on eyelid surgery, he has written that we should be aware of the clear anatomic issues that are important when dealing with people with dark skin as well as prominent eyes- eyes that are slightly forward. When having upper eyelid surgery, one of the most critical things to be sure of is that not too much skin be removed. And as a specialist, Dr. Prasad has seen many of his patients who have had too much skin removed in either the upper or lower eyelids, or sometimes both. Dr. Prasad assessed the pictures of the young woman and concluded that there is some room to remove a small amount of skin in the outer aspect of the eye. He urges to be mindful about people who have African descent or naturally have prominent eyes or even people who have thyroid eye disease. When you focus on the hooding part of the outer aspect, sometimes taking away that hooding makes the eyes look more prominent. One of the strategies he uses for patients who have thyroid eye disease is awareness of that prominence and to camouflage a little bit of it. As far as the risks of scarring and pigmentation changes, he states that there is always that risk in any surgery. http://www.prasadcosmeticsurgery.com