"Hypertrophic," or overly aggressive, scarring may occur in rare patients and, in our opinion, seems more related to the fact that Asian patients are generally much younger than their Occidental counterparts rather than due to ethnicity. Even when the healing scar is hypertrophic (redder, thicker, slightly shiny), the final smoothing and maturation, while slower, are equivalent to non-hypertrophic scars.
Use of the laser as a cutting tool is somewhat controversial due to the olive coloration of most Asian skin. Darker skin tones are more subject to pigmentary disturbance after laser incision and are, in our opinion, more safely treated with the low-tech stainless steel scalpel.
Commercial products (silicone strips, gels, creams) intended to lessen or treat true keloid formation have no noticeable impact on normal eyelid healing and are not recommended. Likewise, we do not recommend any nutritional supplements or the routine use of Vitamin E oil. After ten days, an eye cream (any brand) may be applied to moisturize, although this is not required. Basically, healing takes time.
The term "non-incisional" used to describe techniques in which a less permanent crease is created by the placement of internal eyelid sutures rather than full open surgery is misleading. Most "non-incisional" techniques require two to four small skin incisions and/or multiple incisions made on the back of the eyelid. The scars, while small, may be just as noticeable as those from the more definitive incisional technique. Scars from operations designed to reshape the epicanthal fold can be objectionable; epicanthoplasty is thus seldom recommended.