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What Can I Do to Lessen Scars After Blepharoplasty?

I had upper & lower bleph done 18 months ago. Am happy w/ lower as my bags are gone (am 49 years old & they were aging me more). I am very unhappy w/ the results of my upper as i have a visible indented scar that extends beyod the eyelid crease. In almost all lighting, the scar is visible as it extends approx 1/4 inch &is quite wide. On the other side , it is smaller but is white.

Even make-up cannot hide these scars. I feel that people look at them instead of giving me eye contact. I have to style my hair to conceal these scars. I usually pull my hair back or away from my face but now they must be like curtains hiding these scars.

Please advise if anything can be done to lessen the scars. Tx

Doctor Answers (23)

Poor Upper Eyelid Scars Are Rare

+4

The upper eyelid skin is usually some of the best healing skin on the body, at least from the standpoint of scar quality.  Sadly, you seem to have had difficulty despite that.

From your description, I suggest that you have the scar revised.  Perhaps you had a tight eyelid early in the healing process which put tension on the scar.  During a revision, only the scar will be removed and this will likely not lead to much tension.

The first goal of a revision is too have a smooth scar.  In other words, not dented in.  During the early parts of healing the scar may be mounded up a little, this is normal and should resolve.  A dented in scar is not going to fill in on its own and would need further work.  Aside from trying surgery again, fillers like Restylane or Juvederm could be used.

The second goal of a revision is a scar that is as narrow as possible.

The final goal of a revision is a scar without visible color problems.  If you tend to scar very white, there is little that surgery can offer to correct this.

If your scar ends up dented after the revision, it may be your genetics, or it could be the technique.  You may consider a second opinion.  A wide or white scar is amendable to make-up and is not as severe a problem.  You could also look into permanent cosmetics (specially qualified tattoo artists do this) to blend the color.  Be sure to pick someone highly skilled in this because it is not easy.

Austin Facial Plastic Surgeon
4.5 out of 5 stars 15 reviews

Blepharoplasty scar revision can help.

+3

Hi.

It sounds like your problem can be improved.  You have waited long enough.  An expert upper blepharoplasty scar revision should make the lateral scars a lot less noticeable.

Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Visible sunken upper blepharoplasty scars can be revised and or treated with laser resurfacing

+3

The scars you describe after upper blepharoplasty are not uncommon when excess upper eyelid skin extending out over the side of the brow or lateral eye area is excised during blepharoplasty.

Visible, dented or depressed scars after upper eyelid blepharoplasty usually require revision.

Minor scars can be lessened with laser resurfacing preferably with a fractional ablative 2940 Erbium laser resurfacing alone.

Dented or depressed scars usually require surgeical excision and revision with careful technique. Using the laser to resurface the skin around the scar before the revised wound is closed can help make the resultant scar less visible after healing.

Web reference: http://drseckel.com/scar-removal/new-laser-scar-removal-treatment-with-starlux-1540-non-ablative-fractional-laser/

Boston Plastic Surgeon
5.0 out of 5 stars 24 reviews

Blepharoplasty scar management is definitive

+3

Evident scars are rare after blepharoplasty, but given the popularity of the procedure, occur quite often. I often see patients with visible scars after blepharoplasty elsewhere who are unhappy with their scars.

The preoperative position of the incisions is crucial to the overall success of the surgery.

The management of these scars is very definitive and is based on the reason the scar developed in the first place. The three most common reasons are:

  • Incorrect placement of the scars outside the eyelid skin margins
  • Pigmentation
  • Dehiscence of the cut orbicularis muscle

These can each be addressed precisely after consultation and examination.

Web reference: http://www.surgery90210.com/face/44/eyelid-surgery.aspx

Los Angeles Plastic Surgeon
5.0 out of 5 stars 43 reviews

Determine exactly what you don't like about your blepharoplasty scars

+3

It's unfortunate that your result is not what you had expected. It is very important that you speak with your original surgeon about this. One, it will give you peace of mind that the surgeon knows how you feel. Two, every good surgeon wants to know when things are not absolutely perfect. We're here to make you happy and help you achieve your goals.

In terms of scar management or scar revision:

Dr. Westreich covered many of the options available to you. It's also important for you to decide what aspects of the scar are the most disturbing to you. Is it that it's intended? Or is it the width that bothers you most?

The indentation or depth of the scar could be adjusted independently of the width with a percutaneous release and/or injectable fillers. This may make the scar much less noticeable, because it would then be easily hidden with cover up make up. It's often the change in contour that our eyes first notice, i.e. that the scar is depressed or fixed.

The width may of the scar may or may not be difficult to fix. It depends on the reason why the scar is wide in the first place. Often, scars widen because of tension. If there is tension on the scar after a revision, the scar will again widen out to the same width.

These are just a few suggestions. I hope they help. It's always important for you to discuss these matters in person with a well trained surgeon prior to making any decisions.

Englewood Plastic Surgeon

Natural scar maturation after blepharoplasty takes about 18 months

+2

Natural scar maturation generally takes place by about 18 months. As a result, they are not likely to improve further at this point on their own. The scar that is too wide on the one side may need to be revised (removed and closed again). For scars that are raised or red, simple scar gels that contain silicone as the active ingredient are often very effective. These scar treatments come in liquid gel form or in solid gel sheeting and may be applied to reduce the redness and flatten out scars that are up to 2-3 years old.

Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Eyelift Revision Surgery and Seeking Opinions

+2

Socially visible scars are a common problem and a common reason patients are referred to my practice. I stress to my prospective patients that there is an art to performing blepharoplasty so the eyes appear natural and not have obvious signs of being operated on. There may be some options such as revising the scar so it isn’t wide however, the fact that it is wide may mean there is a relative lack of skin. Seeking additional opinions if your surgeon has nothing more to offer may be the appropriate next step for you.

New York Oculoplastic Surgeon
5.0 out of 5 stars 17 reviews

Scar Revision After a Blepharoplasty

+2

A poor scar after an upper lid blepharoplasty can be typically remedied rather quickly and easily as in office procedure.  This can be done with a minimum waiting period of one year after your surgery.

Web reference: http://www.shahfacialplastics.com/eyelids.html

Chicago Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Eyelid scars

+2

It sounds like a small revision of the lateral part of the eyelid incsion may help to make the scar cleaner and without the depression.

Miami Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

Scar revising

+2

In some case a scar revision can be helpful to hide the scar better. Also massage over time can help to lessen the scar. I would need to see a photograph to properly evaluate you.

Washington DC Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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