Part of the pre operative evaluation for lower blepharoplasty surgery is to assess the amount of skin present. Your surgeon has made a determination as to whether you needed skin removed or not. If you did, then there should be stitches under your lower eyelashes. If you did not, then the surgery was probably done through the inside of the lower eyelid (transconjunctival). Sometimes, the assessment by the surgeon may be slightly inaccurate and someone who was thought not to need skin removal turns out to need skin removal after the transconjunctival surgery. As mentioned by others, there are many ways to address this need, either with laser, other skin tightening technology or a minor surgical skin removal. At any rate, it is much, much too early for you or your surgeon, for that matter, to determine this need. Let things heal, skin will retract (shrink) and scar tissue will be forming over the next several months. Relax and enjoy the ride.
Was skin removed?
Kenneth R. Francis, MD answers: Skin wrinkling after lower Blepharoplasty
I had lower Blepharoplasty done 2 weeks ago. Swelling still remains, which is normal. What I noticed recently is the exessive skin wrinkling on the lower lidsas the swelling goes down. What should I do to eliminate wrinkling? Could it become permanent?
Contact the doctorA: Do absolutely nothing for at least four months.
Correcting the lower eyelids is one of the trickier cosmetic surgery procedures.
In a young face, you cannot tell where the cheek ends and the lower eyelid starts. There is no sharp line between them. So, with surgery, you should try to recreate this smooth, seamless transition. You also have to preserve the shape of the eyes and not make them round.
There are many different ways to correct the lower eyelids and imperfect results are not rare. But at 2 weeks, you should not look at yourself too closely. Assume you will eventually have a great result.
If in several months, there is indeed excess skin or wrinkled skin, there are several things that can be done depending on the exact anatomy. The possibilities include non invasive skin treatments, Botox injections, laser resurfacing, or revisional sugery
A: Give it some time, you may be surprised at the improvement
Matreshka,
2.5 weeks is fairly early to start getting worried about your eyelids after blepharoplasty. Often it takes several weeks to months for the tissues to settle and the swelling to resolve. At the same time, the tissue is healing and the collagen is reorganizing. All of this leads to changes after surgery which may not be apparent yet. However, if after several months you do not see a significant change and still see extra skin, you can have a straight-forward revision or secondary surgery which will help tighten up the extra skin. However, do not be tempted to rush into any revision surgery before your first surgery has completely healed.
David Shafer, MD
A: Too early to evaluate excess skin after Blepharoplasty
2 weeks post-blepharoplasty is too early to evaluate the excess skin. There is often alot of swelling after a blepharoplasty, and you have to give the skin some time to go back to normal.
A: Allow more time for healing
Hello,
Excellent advice given to you by Dr. Freund.
I would also add that since you are only two weeks removed from your surgery you need to allow more time for further healing to occur before making a final assesment of your results (ie. the wrinkling skin on your eyelid).
Once the swelling has gone done, the underlying scar tissue has formed (this is good & normal scar tissue formation), the lymphatic drainage has been normalized and your skin has "settled in", you can discuss any concerns you have with your surgeon and should have many options to get the final result you desire.
If you do indeed end up with extra, wrinkly skin that bothers you, your surgeon may recommend one of the following options:
1. Skin Removal - the extra skin can be "pinched up" and removed
2. Laser Resurfacing - this can provide extra tone and help reduce the wrinkles
3. Chemical Peel - also improves skin tone and improves fine wrinkles
4. Leave things alone - sometimes based on a Patient's anatomy it is actually better to leave some "excess" skin behind so as to avoid complications or altering the shape of the eye too much.
Take Care,
Dr. Jafri
A: Lower lid wrinkling has many causes
A lower lid blepharoplasty can remove 1- excess skin, 2) excess and herniated fat and 3) tighten the muscles and ligaments of the eyes. Surgeons have different techniques that address all or some of these problems.
To address the herniated and bulging fat, surgeons can remove the fat from inside the eyelid (transconjunctival approach) or through an open approach (skin muscle flap).
The loose muscle and ligaments must be addressed through an open approach, but if the ligament is all that needs to be tightened then the surgery can be limited to the corner of the eye (lateral canthopexy). To tighten the muscle as well, the open approach is needed.
When considering the skin, the skin can be removed by laser resurfacing or surgical excision, either way, good surgeons always err on the side of removing too little skin , because the converse can lead to devastating complications.
But in your case, it is quite common for the skin to appear dry and brittle as the swelling from surgery subsides and this may make the skin appear to have many wrinkles. The best thing to do is to relax and consult with your doctor regarding any topical creams that can help moisturize the skin
