By W. Chen
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Extra info for Asian blepharoplasty and the eyelid crease
Very often patients may be overly self-conscious about an issue that matters little to anyone they interact with, or one may need to point out an extreme condition that needs to be corrected before the desired aesthetic outcome can be achieved, for example ptosis. It is important for the surgeon to customize individual aspects of their particular technique for a particular patient. I do not believe I have performed two exactly identical procedures in any of my Asian blepharoplasty patients. I inform my patients that there is a 3–5% probability that they will need touch-up revisions if the creases are uneven.
The swelling will start to decrease by day 4. By day 7 a normal-looking crease form will be seen at a level 40–50% higher than the eventual outcome (in other words, a perpendicularly viewed and measured crease will look like 140% of what was originally designed). 3. The swelling will have subsided by 80% by the end of 2 weeks. 4. The remaining 20% swelling will take another 6 weeks to resolve (the 80 : 20/2 weeks:8 weeks rule). 5. The crease height does not move: it is merely inﬂated up and down as wound swelling occurs and then subsides.
This attitude on the part of the patient or family is problematic when the surgeon and the patient are not communicating on the same level. Many patients who come to the author for possible correction have had the operation performed by a reputable and capable surgeon but are dissatisﬁed with the results. These patients complain that despite their insistence on a ‘low, natural crease’, the doctor gave them a high crease (Fig. 41); that the creases are asymmetric (Fig. 4-2); that the crease disappeared with time (Fig.
Asian blepharoplasty and the eyelid crease by W. Chen