LAM FACIAL PLASTICS

Hi Dr. lam!

I recently had surgery in asia and it went just fine,altho the lids are ''acceptable'' and there were no complications, the lids are way lower than i expected and i'm only less than a month post-op, meaning after 1 year they will be even lower, on top of that my lids have more of a tapered look intead of a parallel one (mind u i had epi as well and he did it real good with the new method ''magic epi").

I received a partial incision and was wondering what ur opinion on partial incision is? My doctor said he gave me partial because i had a good skin texture (I have small pores, and medium skin meaning it's not thick or thin, and i don't have a lot of fat in my eyelids, just enough) so the partial would be permanent on me.

I know most doctors would rather wait 6 months or so before they revise anything and i was wondering why it is that you have to wait that long? besides the fact that the final result don't come till after but if i already don't like the height at 1 month post op- why wait?

Are revision blephs normally advised AGAINST? if so, why? and will it make any difference in healing if i get it done 1 month post-op or 1 year post op?

Will healing time take longer after 2nd bleph and what will happen to the partial scar i already have (10mm above my lashes) on both lids if i decide to go for a higher crease meaning another incision has to be made?

Are more complications and risks usually involved in bleph revisions than in primary ones?

Lastly, maybe the reason why i didn't get the parallel look even though i had a epi on the inner corners is because i only had a partial incision instead of a full one that would 100% guarantee a steady line right across?

I know i ask a lot of questions and i thank you for always answering them every time, but i trust your opinion and knowledge and that is why i'm asking u (altho i already emailed my doctor overseas). My doctor is very skilled, but he kind of contradicted himself like in the office he used the instrument to prop up my eyelid and said ''i can make ur eyes look like this with 10mm'', 1 month post-op and my eyelids are lower htan that..

I'm only in a rush to get a revision because i have a gig this summer and cannot wait any longer so the sooner the more healing time i have before the shoot,

thanks

As you know, I always warn my patients regarding responding to another surgeon's work. I think it is inappropriate and dangerous to do so. I will however make general comments pertaining to your questions. They are done in all caps:

I know most doctors would rather wait 6 months or so before they revise anything and i was wondering why it is that you have to wait that long? besides the fact that the final result don't come till after but if i already don't like the height at 1 month post op- why wait?

GENERALLY, THERE IS MORE SWELLING AND BLEEDING WHEN YOU GO BACK IN SO FAST. SO IN AN IDEAL WORLD, YOU WAIT 6 MONTHS. THAT IS UP TO YOU AND A DISCUSSION WITH YOUR SURGEON.

Are revision blephs normally advised AGAINST? if so, why? and will it make any difference in healing if i get it done 1 month post-op or 1 year post op?

REVISION BLEPHS ARE NOT ADVISED AGAINST BUT THEY ARE TECHNICALLY MORE DEMANDING. IF YOU JUST HAD A PARTIAL INCISION, IT IS USUALLY DOABLE TO CONVERT TO A FULL INCISION BUT I DON'T KNOW EXACTLY WHAT KIND OF PARTIAL YOU HAD DONE OR WHAT WAS INVOLVED. FOR THE SECOND QUESTION, SEE ABOVE ANSWER.

Will healing time take longer after 2nd bleph and what will happen to the partial scar i already have (10mm above my lashes) on both lids if i decide to go for a higher crease meaning another incision has to be made?

I USUALLY PREFER THE FULL INCISION BECAUSE I THINK THE HOLD IS BETTER THAN THE PARTIAL AND THAT THE INCISION IS MORE CAMOUFLAGED SINCE IT IS NOT AN ABBREVIATED SCAR THAT SITS IN THE MIDDLE OF THE EYELID. WHAT I USUALLY DO SINCE I REMOVE ABOUT 3 MM OF SKIN WITH A FULL INCISION IS TAKE THE OLD SCAR OUT WITH MY FULL INCISION METHOD.

Are more complications and risks usually involved in bleph revisions than in primary ones?

YES. THEY ARE MUCH MORE DEMANDING ESPECIALLY FOR DOUBLE EYELID SURGERY SINCE ALL OF THE SCAR TISSUES MAKES IT HARDER TO ENSURE THAT THE LEVATOR MUSCLE IS ACCURATELY IDENTIFIED AND PROPERLY SUTURED TO THE SKIN.

Lastly, maybe the reason why i didn't get the parallel look even though i had a epi on the inner corners is because i only had a partial incision instead of a full one that would 100% guarantee a steady line right across?

USUALLY FULL INCISION METHODS DO GIVE YOU A HIGHER CHANCE OF ACHIEVING THE DESIRED CREASE SHAPE BUT NOTHING IS A 100% GUARANTEE.