Hello doctor, i've an accident 21 days ago, my left eye upper eyelid get destroyed,, doctor who done stitching is general surgeon,, due to his stitching my eye opens at night when i sleep,, now i want blepharoplasty so that my eyelid start covering my eye,,, should it possible now or i wait for some weeks????
Possible to Do Blepharoplasty to Correct Old Stitches After Accident?
Doctor Answers 8
First off, 21 days is too early to discuss revision surgery, further decreases in swelling and healing will change the dynamics of what is going on right now. The problem may get better or it may get worse but you need to let the process of healing run its course. However the problem of you eye not shutting at night has to be dealt with now or you will have damage to your cornea from drying. You should see an ophthalmologist to see what precautions he recommends. He may suggest patching or tapping the eye shut at night. At 4-6 months it may be possible to consider revision surgery to correct your proble\ms.
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Unable to close eye after eyelid repair
This is a rather difficult situation. Your cornea needs to be protected and therefore you need to be able to close your eye. If not for that I would recommend you wait to have the scar mature and then assess options. I would seek the consult of a plastic surgeon to assess the urgency of your condition.
Tal Raine MD
Maturing of lacerations takes months
If your injury was only three weeks ago, the healing process is only beginning. If your eyelid is not closing at night, however, you should apply night eye ointment to keep your eye from becoming dry and getting an abrasion on the cornea. After several weeks, your eyelid may close again, but if it doesn't, a skin graft or local flap would be required to achieve closure; a blepharoplasty would probably not be beneficial.
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Post traumatic lagophthalmos
Trauma which shortens the upper eyelid and results in inability to fully close the eyeball creates the condition known as lagophthalmos. The eye should be treated with eye drops during the day and ointment at night. You should probably try to defer surgery for at least a few months. Consult with an oculoplastic surgeon before proceeding with any surgery.
This needs to heal before having more surgery.
Blepharoplasty is the last thing you need right now. I agree that using a petrolatum base ointment on the healing skin can be beneficial. If you left eye is dry, artificial tears during the day and ointment at night can be very helpful. The eyelid should be allowed to heal for at least 6 months unless there is an extremely good reason for intervening sooner. The reason for this is often things that at first looked horrible begin to heal and calm down. It may be that in six months the area has healed sufficiently that no further work is needed.
The most important remedy at this time is to lubricate your left eye aggressively. If your eye is comfortable by lubrication alone, then you can wait 3 months or longer before surgical correction. If your eye is still uncomfortable, then may need to do surgery earlier. You should get an oculoplastic consulation.
Allow eyelid wound to heal before considering revision surgery
Priority #1 is protection of your eye. It needs to be kept moist and protected from scratches/ irritation. Assuming that your eye can be kept safe, I would recommend avoiding revision surgery on the eyelid until the wound and scars have healed completely which can take 6-12 months. It is likely that you will require a skin graft or local flap to add tissue rather than a blepharoplasty to remove tissue once you've healed completely.
Stephen Weber MD, FACS
Blepharoplasty after trauma
The most important thing at this point is to make sure you keep your eyes moist with regular eyedrops as the tissue is healing. As far as the scar, it is too early to start doing additional surgery. If you have an occuloplastic specialist in your area, this would be the person to see. Good luck.
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