I read that it takes 5-7-10 days for Asian upper eyelids to look presentable. I am 12

days past the surgery. I am wondering whether it's ptosis or the surgeon took out too much

fat and unfortunately resulted in a hollow appearance? I am extremely upset and regretting

my decision for Asian blepharoplasty. Please let me know how long swelling will likely

take to subside. Does blepharoplasty involve taking out a lot of fat from the eyes? Is

dryness a permanent condition?

Thank you for your question!

You presented in your question a lot of the typical questions that people have after Asian

eyelid surgery. Certainly you've done your research and you're asking questions about

ptosis. This is a photo you submitted that I believe 12 days after your surgery and you're

asking whether too much fat was removed and whether you have ptosis. So this was something

that probably was discussed during your preoperative evaluation but it is certainly something that

can be reinforced and I'll share with you how we discuss the recovery period of Asian

eyelid surgery with our patients.

So let's start with what makes the Asian eyelid surgery recovery period a little bit longer

typically than for a non-asian eyelid procedure. Essentially, there is some anatomic factors

and some procedure that has to do with probably why an area of the eyelid we call the pretarsal

area. The pretarsal area is the space between the eyelid crease and the eyelashes. When

Asian eyelid surgery is done and this is a person who has a little bit of extra skin

or almost no extra skin but has fat that is actually blocking the connection between the

levator muscle, the muscle that lifts the eyelid like the world elevator, and the fibers

that we create a crease.

You asked about fat removal. Well, when we do Asian eyelid surgery, very often we're

not actually removing a lot of fat because the more fat you remove, the more relative

hollowing you can get but rather what we do is we look to see if the fat will get in the

way of the attachment we are creating surgically. What we're essentially doing is we're taking

the skin between the crease and the lashes and we're connecting it to the levator muscle.

That creates a little tight compartment. Essentially, what generally happens is there's swelling

and that swelling typically takes time. So when I see my patients, I usually see them

closely in the first few weeks after the surgery to help them feel confident that what they

are experiencing is normal.

So it is normal to have swelling from the crease to the eyelashes. In some people, that

swelling can last for several months and subtle degrees of swelling can make a huge difference

in the appearance. So a lot of times, people will feel panicked that the crease is too

high because the swelling of the pretarsal area causing the eyelid crease to look higher.

So I always explain that where you are at one week, two weeks, one month, three months

is going to be an evolution. If there are other factors such as sinus issues or allergies

or even allergy to the antibiotic ointment, these are things that can prolong the swelling

of the eyelids.

So it's very important that you communicate with your doctor and not jump to conclusions

about your appearance. Certainly people can look like they are hollowed out in the beginning.

This is an area where there's a dynamic architectural change. What I like to do, during the surgery

in some patients and actually for most patients, when we are doing the surgery, we actually

have them open their eyes to take a look of how the eyelid creases in. It kind of gives

a window of opportunity to identify if the eyelid crease looks the way we intend it to

look. If it looks good during surgery then it'll probably look good after surgery. There

are also exceptions and sometimes revisions are necessary, that's a part of cosmetic surgery.

But in your situation, I would suggest to you that you're probably early in drawing

in your conclusions and that you should communicate with your doctor about what your concerns

are. You know your doctor has your photos of you before surgery and can review with

you what you can anticipate. But it just seems that your concerns are consistent with the

typical healing process related to Asian eyelid surgery. But no one knows better exactly what

happened during surgery better than your surgeon. So communication is always very important.

I hoep that was helpful, I wish you the best of luck and thank you for your question!