Eyelid Surgery: Q&A

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is a secondary procedure reasonable for upper bleph eyelid surgery scars?

I am 1 year post op from upper bleph surgery. My surgeon used laser with undisolvable sutures. I have devekoped wide white scars within the eyelid crease but they are very visable when I close my eyes or raise my eyebrows. When eyes ar open there is a slight visable scar on the very inner corner of the eyes. Even after a year the scars still seem to be evolving. My PS (a reputable Occular plastic surgeon) suggested the scars could be cut out with a scalpel, (I think he said he would remove the old sutures- not sure) and re-sutured with a different type type of suture (disolvable) . He said there would be more swelling and bruising than the laser surgery but I would be left with thinner scars. Does this sound reasonable or should I get a 2nd opinion? I trust my PS but am a little nervous about having to go through the healing process again. any input would be greatly appreciated.

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9 Doctor Answers | Asked by Nashville1621 in Nashville, TN

Doctor Answers (9)
Community Comments (0)

Scar revision for unsightly upper blepharoplasty scar

Thank you for your question. It is reasonable to consider scar revision for upper blepharoplasty scars in the case of unsightly scars 1 year after surgery. Sharp excision of your current scar with careful reapproximation may be an option. If you are uncertain, consider seeking a second opinion as you suggest. Good luck.

James M. Pearson, MD

24 reviews

Los Angeles Facial Plastic Surgeon

www.PearsonMD.com

Eyelid scar revision

Upper eyelid scar revision is possible. The scar is unlikely to improve much more after one year from the surgery. If you feel uncomfortable with your surgeon, get a second opinion from an oculoplastic surgeon.

You may consider getting a second opinion about your upper blepharoplasty scars.

I read your concern: Upper blepharoplasty scars heal as a fine white line in nearly everyone. A wide white line could be improved via scar revision, but my concern is that your scar is visible with your eyes open, in the inner corners near your nose. Scarring where the eyelid skin meets the nose may be difficult to correct, as unsightly webbing may occur in this area. In that regard, you should consider getting evaluated by another reputable, experienced blepharoplasty surgeon before... more

Eric M. Joseph, MD

204 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

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Scar revision

Dear Nashville, I agree with the other experts' opinions. Namely, laser surgery can, in some people, cause more scarring then a blade. Not only does the body have to heal from the mechanical injury of the wound, but also from the thermal injury of the laser. How do you heal generally, do you have scars elsewhere? Those are other things to take into consideration. Scar revision is certainly a reasonable option, and... more

Revision might improve the scar appearance.

As you know, any incision we make, whether with a knife or with a laser will heal with a scar. It appears that your scar formation may have been more noticeable than is acceptable to you. Is it possible that the scarring was "thicker" than most due to the laser. Yes, that is a possibility. But the fact remains that everyone heals differently and its quite possible that the response was your body's unique healing response. I believe that the recommendation by your... more

A.J. Amadi, MD

14 reviews

Seattle Oculoplastic Surgeon

seattleface.com

Blepheroplasty scars

If you have enough tissue on your upper lids, a scar revision would be apropriate at this time. I would agree that switching to cold steel is a good idea

David A. Bray, Sr., MD

6 reviews

Los Angeles Facial Plastic Surgeon

drbray.com

It is reasonable to revise prominent or unsightly scars

Generally if a scar is wide or thick, there may have been too much tension across the closure either by removing too much skin or not closing the incision strongly enough to resist the forced acrossed the closure. Given your description of your upper lid scarring, it is reasonable to surgically revise them by excision or cutting out of the scar. The only concern is if you have enough skin for a relaxed closure to be accomplished; otherwise, the problem is likely to recurr. Sometimes, you can... more

Contrary to popular opinion, laser is not an ideal cutting instrument.

Laser creates a lot of thermal damage in its wake that must be healed by the body. There are very few circumstances in my opinion where a laser makes a better instrument for cutting skin than cold steel. Cold steel does not burn the tissues. Sutures can be rapidly removed helping to minimize the appearance of the wound as it heals. In contrast, the laser weakens the skin edges, sutures must be left in much longer. This is less than ideal. Scar revision is... more

Kenneth D. Steinsapir, MD

9 reviews

Los Angeles Oculoplastic Surgeon

Scar Revision After Blepharoplasty

Generally speaking, upper eyelid surgery heals very nicely with thin, hardly perceptible scars. However, the healing process can vary based on the patient and the situation. I think that your Surgeon is offering a reasonable solution assuming enough skin remains on your upper lids for safe removal. The real question is whether or not you are comfortable with your Surgeon and his ability to correct the problem. The fact remains that if you are unhappy with the scars, they... more

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