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A man had Asian eyelid surgery 3 weeks ago and noticed one of his eyes has a different shape. He wants to know what could cause this. Dr. Amiya Prasad, an oculofacial plastic surgeon, observed from his photos that there is swelling and it has a tremendous impact on the appearance of the eyelid crease. This is probably a result of Asian eyelid surgery where it requires a connection between the skin and the levator muscle. The levator muscle is the muscle that lifts the eyelid. This procedure creates a very tight compartment where fluid has a tendency to linger. This applies to both the incisional and non-incisional techniques of Asian eyelid surgery. Although there are examples of people who look good in a week or a month, eyelid swelling can last up to a year although it rarely lasts that long. Typically, enough swelling has resolved by 3-6 months and a patient can have a good sense of their final appearance. In Dr. Prasad’s practice, he follows his patients very closely: he sees them at 1 week, then 3-4 weeks later, then monitors them again at 3 and 6 months. He has observed that some people can have swelling that lingers, with factors such as allergies and sinus problems having an impact. Dr. Prasad is certain that this man's doctor has discussed this with her prior to surgery. This is part of the standard discussion about eyelid surgery, whether it’s an Asian eyelid surgery or a non-Asian eyelid procedure. He must simply wait for swelling to resolve. Surgeons cannot operate on something that’s swollen unless there’s a very strong indication and usually wait until they can manipulate the tissue when necessary. In Dr. Prasad’s practice, he let his patients open and close their eyes even when he is doing Asian eyelid surgery just to confirm that the crease looks like the way the patient wants it to. Dr. Prasad explains that communicating with the doctor is critically important. No one knows the patient’s anatomy or what was experienced during the surgery better than the surgeon. He thinks that waiting it out would probably work out in the patient’s favor. For more information about Asian double eyelid surgery, please visit our website: http://prasadcosmeticsurgery.com/pras...