Dr. Sam Lam Plastic Surgery Forum

Hi Dr Lam,

i read this double eyelid topic on an asian forum
asianfanatics.net/forum/index.php?showtopic=485541
and there are a few things that i hope you can clairfy for me.

1. What does it mean by cutting on the outside or inside? Is there such thing?

2. Once you had an eyelid surgery, is there no possible way to revert it bavk?

3. Like it is mention on the topic over and over again, people with a natural double eyelid have less fat and it is thiner under the eyelid and thicker above the eyelid? Is this true?

4. Will the scar ever fade away completely? when you touch a person's eyes, can you tell his/her had gone through surgery?

5. what can be done to the undereyelid, if it doesnt match the double eyelid? Like usually a person will have small eyes if he/she has single eyelid, so what can be done to make the eye more round, so it will balance.

thanks

HERE ARE THE REPLIES IN ALL CAPS:
1. What does it mean by cutting on the outside or inside? Is there such thing?

I DON'T KNOW WHAT YOU ARE TALKING ABOUT. I ASSUME OUTSIDE MEANS A FULL INCISION METHOD AND INSIDE MEANS A SUTURE METHOD WHERE THERE IS NO CUTTING. IF NOT, THEN ALSO AN OUTSIDE FOLD REFERS TO THE INNER PART OF THE EYELID (NEAR THE NOSE) THAT RUNS PARALLEL WITH THE EYELID MARGIN, WHEREAS AN INSIDE FOLD REFERS TO THE INNER PART OF THE EYE IN WHICH THE EYELID CREASE FOLDS DOWN AND TOUCHES THE EYELID MARGIN.

2. Once you had an eyelid surgery, is there no possible way to revert it bavk?

IT IS PRETTY MUCH IMPOSSIBLE TO UNDO AN EYELID CREASE WHEN DONE.

3. Like it is mention on the topic over and over again, people with a natural double eyelid have less fat and it is thiner under the eyelid and thicker above the eyelid? Is this true?

NO, THAT IS INCORRECT. PEOPLE WITHOUT A CREASE HAVE TYPICALLY THE SAME AMOUNT OF FAT. THE FAT JUST HANGS LOWER DOWN TO THE EYELID EDGE (MARGIN) SINCE THE MUSCLE DOES NOT ATTACH TO THE SKIN THAT PREVENTS THE FAT FROM SLIDING DOWN. THIS IS WHY IN GENERAL I DO NOT PREFER TO REMOVE THE FAT BUT TO REPOSITION IT HIGHER. ALSO, THAT MOVE CAN AGE SOMEONE, AS I BELIEVE IN FAT GRAFTING THE EYELID. JUST MOVING THE FAT UPWARD BEFORE THE CREASE IS MADE IS SUFFICIENT TO ELIMINATE THE PUFFY LOOK TO THE EYE WITHOUT MAKING SOMEONE HOLLOW OR LOOK OLDER. IN SOME KOREANS IN PARTICULAR WHO HAVE A LOT OF FAT, I WILL REMOVE A VERY TINY AMOUNT AS NEEDED.

4. Will the scar ever fade away completely? when you touch a person's eyes, can you tell his/her had gone through surgery?

YOU SHOULD NOT BE ABLE TO TELL BY TOUCHING. OBVIOUSLY, A SCAR BY DEFINITION WILL ALWAYS BE THERE. GENERALLY, IT SHOULD REALLY NOT BE VISIBLE AT ALL EVEN AT CLOSE RANGE OVER TIME, ESPECIALY SINCE THE "SCAR" OVERLIES WHERE THE CREASE IS NOW.

5. what can be done to the undereyelid, if it doesnt match the double eyelid? Like usually a person will have small eyes if he/she has single eyelid, so what can be done to make the eye more round, so it will balance.

THERE REALLY IS NOTHING TO DO WITH THE LOWER EYELID SINCE THAT IS NOT NECESSARY UNLESS YOU ARE AGING. FOR THE CANTHI (THE INNER AND OUTER PART OF THE EYELID WHERE THE UPPER AND LOWER EYELIDS TOUCH), YOU CAN DO PROCEDURES LIKE AN EPICANTHOPLASTY (INNER PART TO OPEN THE EYE FURTHER). I ONLY DO THAT WHEN SOMEONE WANTS THAT DONE BUT IN MOST CASES A LITTLE EPICANTHAL FOLD CAN BE ATTRACTIVE. THE LATERAL CANTHOPLASTY REALLY IS EASY TO DO BUT IS MAINLY HYPE. VERY LITTLE GAIN IS ATTAINED WITH THE LATERAL CANTHOPLASTY.

Hi Dr Lam

thanks for replying!

regarding Ques#4
i find that when i close my eyes, and slowly opening wider and wider until i reach maximum...i can see the scar is shinny comparing to the normal skin...it seems like it has been cut before....and also when i feel the scar with my finger, i can feel that the skin is not even. It seems like my eyelid fat (like the fat from the crease to the eyelashes) is too much...and it makes the scar look more visible since it's puffy. Although surgery has been done 2 yrs + 4 months ago...so i assume any swelling, healing, etc is/are not the causes.

also i feel it really really weird when ppl stare at me, it makes me feel that they know i had a double eyelid surgery done. So far, 2 people asked me, but that was back when i was only 5 days after surgery and 4 months after surgery (so the scar is like a red line). But then about 1 year + 4 months after surgery , there is this person who look at me really really weird...it seems like they know or can see something. I dont know if i am thinking too much or what not...

Any advice will be helpful.

Also, if the shape of my crease is open (towards the nose), will it be possible to make a small cut and change it to flare shape (it start out as 0 mm and getting bigger and flare across)

thanks

we can possibly change the shape of the inner eyelid but i think you really need to stop looking at and feeling your eyelid crease. you are getting probably paranoid at what people think. most likely people are looking at the fact that you think they notice something when in fact they are reacting to the fact that you are acting weird when you see them.

do me a favor: WATCH MY SELF PERCEPTION AND PERCEPTION THAT OTHERS HAVE OF YOU VIDEOS. those two videos will show you how most of my patients look at themselves after a procedure. you can find them in my media center under "postoperative video companion series". seriously, these videos on psychology will help you tremendously. I force all of my patients now to watch these videos following ANY procedure with me so that they don't get into the psychological situation you are finding yourself.
best,
sml