From surgery to 2 years 5 months later

My Eyes

Before my blepharoplasty and epicanthoplasty operation, this is what I looked like:

• Female, 28, of Chinese descent.
• I had small, narrow, monolid eyes, mild ptosis, thick eyelid skin. 
• Short, sparse and straight eyelashes that point downwards.
• My opthamologist measured my eyes and said I was 28-34-28 (34mm being the gap between my eyes).

Why Blepharoplasty?

For aesthetic reasons and to a lesser degree, medical reasons.

I wanted:

• to increase my peripheral vision. This will make wearing contact lens easier. 
• to lessen my astigmatism by increasing my peripheral vision (though that's not medically proven in my case). I have 'Against-the-rule' 2.5 degree astigmatism in both eyes so my vision is distorted. Eg. circular lights are elongated to me (American football standing on its end). But due to ptosis, I can't see the full oval, I only see the bottom 2/3. 
• eyelashes that don't point down
• ptosis correction, by lifting up the levator muscle
• look nicer.

Day 0 - The Day of the Operation

• Video of the actual surgery can be found here (WARNING: Graphic medical video). 
• Performed by opthamologist Dr Darmayanti, SpM at Jakarta Eye Center, Menteng in Jakarta, Indonesia. She is an opthamologist with oculoplastics training.
• Surgery took approximately 1 hour. 
• Parallel crease, 6-7mm tarsal height.
• Y-V medial epicanthoplasty. This supposedly has very little scarring but not in my case, as you'll see later.
• Incisional method was used because fat and muscle needed to be removed. Also, ptosis correction procedure required attaching the levator muscle to tarsal plate (ie. statis crease).
• Under local anaesthesia. I was given a choice of general or local but my Internet research showed that local anaesthesia was the way to go. I'm glad I did because throughout the surgery, there was a lot of patient-doctor communication required (eg please open/close your eyes) so the doctor can measure and make any adjustments if necessary. My right eye was sewn/undone at least 4 times until the doctor was satisfied that it matched my left eye.
• I should have plucked my eyebrows and got a full facial done before the operation!
• After the operation, my vision was blurry for about 3 weeks. The first 2 weeks were especially blurry because ointment kept getting into my eye. 
• On the way back home, blood continued to leak from the inner corners of my eyes. 
• The Dr prescribed some Tranexamic acid to stop the bleeding (1 tablet to be taken twice a day, for 2.5 days), antibiotics for 10 days (I think) to discourage infection from setting in. It was Ciprofloxacin, and a clear ointment to keep the stitches moist (I forget the name). 
• I was given 2 eye guards and medical tape to wear to sleep. To be worn for 2 weeks.

Day 1: The day after my surgery

•  I noticed my eyes were uneven. My right eye was rounder than my left.
• My eyelashes poked forward unnaturally.
• There was a lot of dried blood on the crease. I wasn't sure whether to clean it or not. I tried cleaning it but it wasn't easy. The nurse said I should only use cotton buds to clean my eyes. 
• I begun to notice yellow bruising below my eyes. You can sort of see it in my left eye.

Day 4:Lots of yellow bruising below eyes

Day 5: Stitches removed (except for the ones in the inner corner of my eyes which weren't ready).

  
Day 6:

  

Day 7: Smiling so you can see the double crease fork in my outer left eye

• My crease does not follow the incision line so that's why there's two lines. 
• You can still see the stitches in the inner corners of my eyes.

  
Day 11: Remaining stitches removed from inner corners and some that were overlooked from Day 5.

Day 15:

Day 18:

Day 26:

• Finally got around to tidying my eyebrows. I went to the salon and thought I could use the threading eyebrow method but it was impossible because I had to use my fingers to stretch my eyelids (not recommended). Salon lady ended up tweezing my eyebrows instead.
• You can start to see the scars forming in the inner corners of my eyes.

Day 28:

  
Day 32:

Day 38:

Day 44: I found and removed one stitch from the red patch of scars of my left eye (start of crease).

• You can see the scars getting bigger. It's starting to stretch higher up.

Day 49: 3 forks

• Eyes open photo: Scars are getting bigger to the point where you can see 3 forks: one in my right eye, and two in my left. The two in my left are at the start and end of the crease.

Day 50:

Day 53: close-up of scar

• I decided to see the doctor about these scars. It looked like it was growing bigger and harder.

Day 54: Just after steroid injection 

• It was really painful, especially when the doctor injects into the hard scars underneath the skin. My skin was stinging for about half a day.

Day 61: Skin discoloration due to steroid injection (cortisone)

• You can see a pale discoloration below the corner of my right eye. Scars in the corner of my eyes are still present. It's been over a week since the steroid injection. 
• There appears to be a vertical dent about 2-3mm below the corner of my left eye. Caused by injection.
• In the outer corner of my left eye, you can faintly see a discoloration. It's not so obvious which is good.

• Close-up of the skin discoloration in the outer corner of my left eye. Due to steroid injection.

•  I noticed that my eyelids seem somewhat 'heavy' (or maybe this is excess skin). It's sort of protruding or hanging over the crease. Compare with previous photos of my eyes closed.

 Day 106 (3.5 months) : 1.5 months after steroid injection

• The scar in my right eye is almost gone although you can see a small scar extend downwards in the inner corner. The discoloration has disappeared.
• The scar in my left eye is not so obvious anymore (in the above photo) but it's clearly there (see below photo with my eyes closed). The scar remains red and raised but it is soft to touch. The indentation is still there although not so obvious.
• Doctor says I don't need another steroid injection into it, although if I want to get rid of it, she recommends I wait until at least April 2011 before I get the scar excised and re-stitched. That would require going back to the operating room and spending at least another US$200 or so . She explained that a possible complication is that a new scar might form. At this stage, I'm not keen on having any more surgical work done.
• The outer crease line still does not follow the incision line but I'm okay with it.

Day 121 (4 months) : 2 months after steroid injection

•  Little change from photos of Day 106. 

Day 317 (10.5 months) :  update

•  The scars have disappeared except for a dent in the corner of my left eye (see circle). It's not so obvious from far and I can cover it up with concealer.
• The eye shape is different due to the excess skin hanging over my left eye. The doctor could have excised the extra skin but didn't want to cut away too much as she had already excised fat and skin. I'm satisfied that she took a conservative approach, rather than cut too much off. I've heard horror stories of people who can't close their eyes because too much skin had been cut off!
• As for the tapered crease on my left eye, it's higher than the right eye but I don't think this is the fault of the doctor. If you look at my surgery video, you'll notice that the doctor did mark a line before she started cutting, so, I'm satisfied that the crease she drew and cut are the same. In my non-medical opinion, if the doctor had cut off more skin from the middle, you would see a nicer shape and the crease would taper downwards like the right eye. 
• The parallel crease near the inner corner of my right eye does seem a bit un-natural as it curves down quite a bit so that when I close my eye, the line goes downwards (see below picture of me with closed eyes). 

•  With both eyes closed, you can see the puffy but soft wrinkly scar in my left eye. I suppose I could get that cut away but I'm fine with it. It looks kinda hideous when my eyes are closed but most of the time, I have my eyes open so people don't see it. If I was unhappy with anything, it would be this. I don't think this was my fault yet I don't want to point fingers either. Why I think it might have been a medical blunder is because there were some problems like stitches left inside longer than supposed to, and during the actual surgery, the assistant doctor put too many stitches in, and they had to be removed, so that may have caused this (though you won't see the video footage of that as it's been editted by the clinic). Anyway, no sane doctor would admit fault and I'm not an expert. Only another cosmetic surgeon would be able to tell whether this was done badly by the doctor or just my body's reaction (or a combination of both).

•  Side view of my eyes to show how much my skin hangs over my crease. If more skin was cut off from my left eye, it would be higher, and nicer, of course. Because my skin hangs over, it pushes the middle lashes down. 

Day 876 (2 years 5 months) :  update

• Upon Kim's request, this is an update of how I look now, 2 years and 5 months after my surgery. If I close my eyes and feel the inner corners of my eyes, I think there is still a small keloid scar underneath. It feels hard but it's not raised. I'm just going to leave it as is. 

• This is how I usually look. I wear glasses and don't wear makeup except on special ocassions or when I can be bothered, which is almost never. 

• With eyes closed, you can still see the scars. Makeup artists can tell I've had eyelid surgery because of the scar when they do my eyes. Otherwise, they can't tell. 

Before surgery

After surgery

•  So you can see the difference without makeup. 

Would I go through blepharoplasty and epicanthoplasty again?
Yes, I would as overall, I'm satisfied with my new look. No doctor is perfect 100% of the time. I consider this 80% and that's good enough for me!