Eyelid designing differs from race to race because of some important differences in the anatomy.What one does for a normal Caucasian eyelid is completely different from the Asian eyelid with plenty of fat,absence of folds,low tarsal plate and other problems like type 4 skin which is more prone to scarring and hyper pigmentation post op.
As a result, I have to plan differently for each eyelid that I design ;the client may have an orbital septum that is too loose and would need some amount of plication. If the patient has a hollow look,some amount of fat contouring may be needed, And so on,
One of the biggest challenges is not in correcting asymmetry ,(usually after a badly done blepharoplasty elsewhere that is referred to your unit,) but the difficult and puffy Asian eyelid that needs to be reshaped completely.
Over the years,from 1998 - 2017, I have seen several presentations that require different approaches to get optimal results. The learning curve is long,but one does well to use standardized techniques so that results are generally acceptable and uniform for all.
pic: correcting iatrogenic asymmetry
neo upper sulcus design @ 5 days
same @ 2 weeks
this right eye had a stitch reaction and needed some revision(below),but looks ok @ day 7 - the right is edematous ,more than left
and there is crepping-this is expected and normal
it will settle as the fluid collection gets absorbed
the eyelids will equalize soon and mold well over the next few months
Note: improvement takes time but eyelids molding into a good shape-here you see some edema over the tarsal plate which will decrease over the next few days and weeks
One word of advice: Hey, be patient ! It takes time to work on a Mona Lisa. You will not be disapppointed if you know that things ,even aesthetic plastic results do take time.
Asian eyelid crease design (moderate) @ 5 days and 5 years..note the subtle crease