Because the primary goal in Asian cosmetic eyelid surgery is the creation or alteration of the upper eyelid crease, shortcomings with final crease position take on added significance.
Since the problems listed below are by no means rare, some patients undergoing double eyelid surgery will not be pleased with their ultimate outcome.
1. Asymmetric eyelid creases - Unmatched creases different in shape, depth, length, and/or height may present a problem. Some slight final asymmetry is not unusual and may occur even in the hands of a highly-experienced surgeon. External factors independent of surgical technique (such as preexisting facial, brow, or orbital bone differences) may also impact on final crease position.
2. Overly high eyelid crease - If the skin incision is placed too high above the eyelashes and/or excessive skin is removed, the final eyelid crease may sit at a higher level than desired.
3. Undesirably shaped eyelid crease - Variations in the shape of the eyelid crease are discussed elsewhere. If a patient desires, for instance, a nasally-tapered crease but ends up with a parallel crease, he or she may be disappointed.
4. Hollowness - If too much fat is removed, a more rounded semilunar crease may result and the typical fullness of the Asian upper eyelid can be lost (although a few patients may be seeking this result).
5. "Westernization" - If a patient without a pre-existing eyelid crease desires only thinning of a baggy eyelid but ends up with an obvious new crease, he or she may be disappointed by the unintended cosmetic change. Furthermore, aggressive surgery may create a crease that . . .
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