Dr. Sam Lam Plastic Surgery Forum

Dr. Lam,

I have a question about Asian double eyelid surgery. My left eye has the crease, but not my right eye. So I'd like to get the crease on my right eyelid. But I heard you don't do just one lid. You have to make a cut on both. So I was just wondering: How would you make a cut on my left eye which already has a crease, given that I'm satisfied with how it looks now? Would you be super-imposing the cut precisely on top of my natural crease? Would that be redundant and unnecessary?

Personally I thought it makes sense to just make the cut on my right lid and use the crease on my left lid as a reference to ensure symmetry. Other PSs I've talked to also said they normally do one given my situation. But I believe each PS has their own philosophy and technique. So would you please enlighten?

Zoe

it is very very very hard to achieve symmetry by simply doing one side. the crease can be slightly deeper or less deep, slightly different shape or longer or shorter, etc. if you do just one side. if you have a crease on one side, i follow that crease and match it on the other side. by making the exact same surgical crease on both sides, there is a much higher chance of proper symmetry.

the next problem with the "crease" is how deep is the fixation. if the side with the crease has a pretty good fixation, your eye will be open a certain amount (that is how wide the eye aperture is when you are just looking at me directly). if i make a perfect crease on the other side and you have say an 80% creased fold on the side that you like, the side where i create the fold will have a more open eye. having a crease is not an all or none proposition. there are shades of gray. you may think you have a perfect 100% crease on that side but you may have 90% crease meaning that it is pretty well formed but not as deep as if i showed you a friend of yours. if i made that crease on the other side height for height the same, the creases would not look the same. it is just way too difficult to try to get symmetry.

as far as recovery, you will have a much harder time with one side. let me explain. it takes one year for all of the micro swelling to go out. it takes 2 to 3 months for the major swelling to go out. if your left eye for example was to be the one that i did, you would think i made an asymmetric crease for an entire year until they evened out. imagine one slightly swollen eye for a few months. it draws 10x the attention than both creases being slightly too big by say 2 mm as the swelling comes down rather symmetrically.

hope all that makes sense. but doing one side may seem logical but it is far far far from logical if you truly understand how a crease occurs in nature and also the second point about recovery.

Thanks very much for the reply. Now it makes a lot more sense

wondeful! always love it when i can help someone see what i see.
best,
sml