Dr. Sam Lam Plastic Surgery Forum

Hi Dr. Lam, I am a high school senior who's looking to get double eyelid surgery during the summer. I've been searching for local plastic surgeons around the Houston area but I stumbled on your site and I'm very interested in having the procedure done at your clinic.

First, I have a few questions I'd like to have answered about the procedure. Which methods of surgery do you use for blepharoplasty? I know there is incisional and non-incisional, is there that you recommend for patients? Can you explain the differences between the two procedures? Which has less noticble scarring? My eyelid skin is quite thin and I do have the "mongolian fold". I have small (not noticible) double eyelids with a tapered crease. When I wear eyelid glue, the small crease is also creased along with the large crease made with glue. Can surgery correct it so that only the larger fold is there?

How long is the recovery time usually? If swelling can go down quickly I'd consider getting the procedure done earlier during spring/winter break.

Can I possibly send you a picture of my eyes and the result I'd like to have to your email for your review? Thank you for your time!

first, I have a few questions I'd like to have answered about the procedure. Which methods of surgery do you use for blepharoplasty? I know there is incisional and non-incisional, is there that you recommend for patients?
YES, I USE THE INCISIONAL TECHNIQUE.

Can you explain the differences between the two procedures?
YES, THE NON-INCISIONAL TECHNIQUE DOES NOT LAST. I HAVE SEEN OVER 90% OF THEM GO AWAY PARTIALLY OR COMPLETELY BY 1 YEAR.

Which has less noticble scarring? My eyelid skin is quite thin and I do have the "mongolian fold".
OF COURSE, THAT IS A LOADED QUESTION. WHEN YOU DON'T MAKE AN INCISION OF COURSE THERE IS NO "SCAR". HOWEVER, THE INCISION TECHNIQUE IF KEPT LATERAL TO THE MEDIAL CANTHUS SHOULD NOT SCAR BECAUSE REMOVING 1 TO 2 MM OF SKIN AND CLOSING IT CREATES A LINE WHERE THERE IS A LINE ANYWAY, I.E., AT A NEW CREASE LINE. JUST LOOK AT THE FINE LINE THAT IS PRESENT IN SOMEONE WITH A WELL DEFINED CREASE. THAT IS WHAT YOURS SHOULD LOOK LIKE. I HAVE NEVER HAD BAD SCARRING OF ANY KIND WITH THIS. MY LINE IS SO VERY HARD TO SEE AND LOOKS JUST LIKE A LINE THAT WOULD BE SEEN IN SOMEONE BORN WITH A CREASE. HOPE THAT IS CLEAR.
I have small (not noticible) double eyelids with a tapered crease. When I wear eyelid glue, the small crease is also creased along with the large crease made with glue. Can surgery correct it so that only the larger fold is there?
YES, TYPICALLY A STRONGER CREASE CAN OVERPOWER THE WEAKER CREASES BUT I WOULD HAVE TO SEE YOUR CASE SPECIFICALLY.
How long is the recovery time usually? If swelling can go down quickly I'd consider getting the procedure done earlier during spring/winter break.
THT IS THE REAL PROBLEM. IT CAN LOOK UNNATURAL FOR EVEN 1 TO 2 MONTHS WITH IT LOOKING VERY UNNATURAL FOR 1 TO 2 WEEKS. YOU NEED GLASSES TO COVER UP THE ABNORMALITY AND IT CAN TAKE A YEAR FOR ALL LITTLE SWELLING TO FULLY GO AWAY.

Can I possibly send you a picture of my eyes and the result I'd like to have to your email for your review? Thank you for your time!
SURE. REMEMBER PHOTOS THAT I CANNOT GUARANTEE AN EXACT CREASE WHEN YOU SEND ME A PROPOSED CREASE BUT I CAN SEE BASICALLY WHAT YOU ARE WANTING. MY EMAIL IS SAMLAMMD@YAHOO.COM OR YOU CAN SEND ME A PRIVATE MESSAGE HERE.
best,
sml

Thank you for your fast reply.

I just feel like 2 months to one year of recovery time before the crease looks natural is a bit long and full incisional seems the most invasive of all the types . A family member told me that the partial incision method is good for people who are younger and the chances of disappearance are low. Can you tell me anything more about it and do you operate using this procedure? I just want to know all the options before I make the decision to go through with the surgery.

hi,
i used to do a ton of partial incisions but now i have completely stopped for several years due to multiple problems. here they are:
1. the partial incision has a high failure rate because the entire fixation is being held by 1.5 cm long fixation. it is simply put not strong enough.
2. it is the worst scarring that i have seen. here is why: first as i mentioned in the last post a tiny incision that falls a long a natural skin crease is normal looking. a partial incision that starts and stops along the eyelid looks completely unnatural when your eyes are closed because you can see this little start stop of a crease. i hated that so i have stopped.
3. the entire procedure is based on sutures holding the crease in place. if you put removable sutures, the crease does not hold. the prominent with these permanent sutures is that they spit out over time and they thereby create problems. compare to my sutures are all out by a week.

you look like a good candidate for the full incision but if you want a partial or a non-incision, you will fail and i won't perform those procedures. some residual swelling that lasts a few months is worth it in my opinion for a lifetime of a good result. however if that is more than you are willing to bear, you can get a partial incision or a non-incision but you have to find another surgeon, as i won't do them anymore.
sml