Removing Scar from Eyelid Surgery?

Question

The scars from the incisions on the lower eyelids are still quite prominent after almost 6 months now. Is there a product or treatment I can apply to reduce or eliminate them. I hear there are scar creams and such but I'm not sure how effective they really are for incisions like this.

Richard D. Gentile, MD · Answer

Scar therapy gels with active ingredients such as steroids, Vitamins A and E and Silicone may help.  If persistent I would explore ablative or non ablative fractional laser therapy.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Vu Ho, MD · Answer

Keep your follow up appointments with your surgeon.  Your surgeon can best guide you as to what topical or laser therapy would be most appropriate to improve the appearance of the scar. Topicals containing Vitamin A, Silicone or Vitamin E may help along with sun avoidance, but you should have the area evaluated by your surgeon first.

Jed H. Horowitz, MD, FACS · Answer

Revision SurgeryScar creams such as BioCornium can help.

Revision eyelid surgery should be done at least 6 months
after the initial surgery to allow time for healing and tissues to soften.  Asymmetries, excess skin, fat rolls,  fat malposition can all be improved.  Other treatments may include laser or
chemical peels to tighten skin and improve texture

Leila Kasrai, MD, FRCSC · Answer

At 6 months after your surgery, your scars should not be as visible as they were in the early stages of your recovery. They should be well on their way to becoming faint and thin, as mature scars normally appear. If your scars are still very prominent, I suggest you see your surgeon to have them checked out. A nonsurgical treatment can help, or you may require scar revision (which would be rare).

James R. Gordon, MD, FACS, FAAO · Answer

The treatment for a scar on the lower eyelid would depend on how it looked and how much skin is left. If the scar is not very noticeable, nothing should be done. If it is very unpleasant, laser resurfacing may be considered. If there happens to be enough skin left over following the operation, then revision of the scar is possible.

Lewis Albert Andres, MD · Answer

Hello! Thank you for the question!  It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.Hope that this helps! Best wishes!

Ivan Wayne, MD · Answer

In most cases blepharoplasty scars may be red or raised
right after surgery. Over time they typically flatten and fade out. At 6 weeks
you are early in the healing process, be patient, you should see improvement. There are some topical steroid treatments that may help speed up the smoothing process, and occasionally using a laser may be helpful as well. Consult an expert in person.Good luck and I hope this helps.

Ronald J. Edelson, MD · Answer

The scars should have pretty much disappeared by now.  You may need a scar revision which is not at all uncommon following eyelud surgery.

Richard J. Bruneteau, MD · Answer

Whenever an incision is made scarring is inevitable. The
eyelid is an area where scarring is usually minimal and
the scars are well hidden in this location. It usually takes 12-18 months for
scars to reach their maximum recovery.

Local
wound care can minimize the potential for adverse scarring following surgery.
In the immediate post-operative period, removing sutures in a timely manner can
minimize adverse scarring. Avoiding crusting and scabbing of the eyelids by
keeping them well lubricated with ointment can minimize indentations in the
scar as well.

A
variety of topical agents have been used in combination with massage to
minimize scarring. These include mederma, vitamin E, vitamin A and steroids. In
addition it’s important to use a sun block whenever outside. In the vast
majority of patients results are excellent when this approach is utilized.

Paul F. Vanek Jr, MD · Answer

One of the ways that is best to treat eyelid
subcilliary incisions is proactively. 
The first is one of technique. 
Running subcuticular suture has less chance of milia and
inflammation.  Depending upon where the
scar is there may be some heightened thickening because it may have been too
close to the lash line.  Without
examining you it is difficult to make a determination as to whether this is an
individual variability or a technical feature where the incision was placed.Certainly early scar management with upward massage
and gentle massage with appropriate scar emollients can make a difference.  I typically start my patients on scar
management within 10 days after surgery and most patients at 7 days.  However, if some time has gone by and your
scar is not to your satisfaction, there are laser treatments that may optimize
your circumstance.  I would be
re-evaluated by a board certified plastic surgeon and see whether or not there
is anything that should be done at this juncture that wasn’t done at the time
of the original surgery.  If nothing was
recommended, then you may have to determine as to why that was the case.

Removing Scar from Eyelid Surgery?

Answers (18)