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A woman is having problems with allergies and swelling causing the crease in her left eye to disappear. She had incisional double eyelid surgery and wants to know if she needs a revision. Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that the challenge of Asian eyelid surgery has to do with several factors. He says that when doing this type of procedure, no two surgeons are exactly the same. The factors that affect the outcome are whether or not there’s excess skin, if the skin is thick or thin, and whether or not there’s fat present. There are also intra-operative issues such as the connection made between the skin and the levator muscle and how well that holds. Dr. Prasad says that placing a piece of tape on the eyelid margin will actually force the eyelid to crease inward. However, he would suggest based on the absence of a physical exam and not being able to tell what her skin quality is or if her eyelid will cooperate, the non-incisional method or the suture technique that her surgeon suggested is possible to achieve this type of result. However, if she closes her eyes and the eyelid skin pushes away from the underlying muscle, then that crease is not likely to hold very well. If with the tape in place and her eye moves well and her surgeon really feels that this is possible, then it is probably worth pursuing. As long as there is no excess skin, then a non-incisional approach or suture method can create a necessary fixation for the eyelid skin to fold-in in a desirable height. Dr. Prasad thinks that the best case scenario now is that she discuss with her surgeon. He says that this is generally a low risk procedure because no skin is being removed and the eyelid is not being opened up fully. It just involves several little entry points along where the desired crease is placed then the sutures are placed in those entry points to engage the levator muscle. He thinks that’s this is a decent option in terms of trying to achieve that eyelid fold. She should meet with her doctor to get a clear understanding of the process and the likelihood of her desired outcome. For more information about Asian double eyelid surgery, please visit our website: http://prasadcosmeticsurgery.com/pras...