Heavy, swollen look above the double eyelid fold or crease can occur after the double eyelid surgery. This is especially common after having an incision double eyelid surgery. This is because after making an incision, the lymphatic channel that drains the fluid is disrupted. Therefore, fluid tends to accumulate below and above the double eyelid fold. This creates a puffy swollen appearance. Furthermore, performing ptosis surgery also increases the duration of the puffy or swollen appearance above the double eyelid fold or double eyelid crease. This is because, after the ptosis correction, the patient does not elevate the eyebrow in order to open eyes. So with the descent of the brow, the thick brow skin give a perception of a puffy upper eyelid above the double eyelid fold or double eyelid crease.
This brings another misperception that removal of eyelid fat will eliminate the puffy appearance above the double eyelid fold or double eyelid crease. However, eyelid fat is a special fat that acts as a cushioning effect from trauma and as a lubricating effect for the levator muscle (eye elevating muscle) to glide. If a person manually raises the brow or forehead, then one will see that puffiness above the double eyelid fold or double eyelid crease goes away. Thus, if the swollen effect does not improve after 1 year from surgery, then one should consider having some sort of brow-elevating surgery.
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