This patient came to us with multiple folds that developed after eyelid surgery at another clinic.
She had been operated on several times at the same clinic without improvement, and arrived with the sutures still in place.
Immediately after surgery, the multiple folds were gone.
She is still swollen, which tends to mask any subtle creasing above the incision line at this stage.
For reference: if multiple folds remain in the immediate post-op period, it usually means the underlying adhesions were never fully released.
So the early post-op view should show no multiple folds. The rare exception is when the skin above the incision is unusually thin and may crease slightly — but this is uncommon.
One month post-op. The medial portion can develop some scar-tissue ridging that creates a crease. In most cases, this softens with time.
Ten months post-op. The multiple folds have completely resolved.
The crease line itself is uneven, however, due to scarring.
Early revisions generally have to use the existing crease line, so any line refinement is performed at the six-month mark.
A separate fee usually applies for that second-stage refinement.
We will therefore plan a second crease-line refinement. Several factors can leave the line uneven.
Significant scarring.
Or a crease design that does not follow the natural sweep of the eye.
These two factors usually account for it. Since the original design from another clinic differs from how I would have planned the crease, we will redesign and operate again.