Should Blepharoplasty Scars Be Less Evident by Now?
- Asked by ksusanb in San Francisco, CA
- 5 years ago
I had eyelid surgery 5 weeks ago and my scars are still prominent even with makeup. I have followed recovery instructions and use an oitment my doctor had me start 5 days after surgery to hasten healing.
My scars are not only a very visible and long redline, they also are thick and raised -- very promenent when I close my eyes and touch my scar. The doctor said this is no problem, such evident scaring is normal at 5 weeks. However, I have read in more than a few articles and websites that eyelide scars should be not much noticeable by this time.
Am I impatient? Or, if red, thick texture lines at 5 weeks is not usual, what should I do? This is my second eyelid surgery. Does that make a difference?
All incision scars go through a maturation phase
This is a good question.
Whenever you have a wound or incision, the healing scar must mature, which involves multiple phases of collagen transformation. At six weeks, the collagen is the thickest and then over several weeks flattens. At the same time, the overlying epidermis of the skin turns red or pink and then over several weeks returns to your normal skin color. However, incisions may still be distinguishable depending on factors which you really can't control - genetics, infection, etc. However, blepharoplasty incisions tend to heal very well. The best way to help your incisions is to leave them alone and allow the healing process to occur. Many ointments and lotions cause irritation, especially with continued use. Another important factor for healing incisions is to protect them from the sun with SPF lotion or, as in the case with blepharoplasty, wearing sunglasses.
I hope this was helpful.
David Shafer, MD
Don't panic, but there may be ways to speed blepharoplasty recovery
Don't panic. Upper eyelid incision scars usually heal beautifully with barely perceptible lines. Occasionally, these incisions will take longer to heal, especially if large amounts of skin were removed or the incision was extended farther to the outside to remove more skin.
The skin involved in healing is thicker in these situations and can take longer and remain thicker for a longer period of time. All this being said, what I usually have my patients do is to massage the scars gently 3-4 times per day and try to avoid using makeup or cosmetics that may create further irritation, redness, and swelling.
I also offer my patients pulsed-dye laser treatments combined with some injections to speed the softening, flattening, and redness reduction of their scars. Time alone will help clear the scars, but these treatments can speed things along.
Patience is a virtue
Unless you have an infection, you should be patient as scars of the uppr lids are usually the most imperceptible. Sometimes, if large amounts of skin is removed, there can be a noticeable transition between thicker skin of the upper part of the lid and the thinner skin of the lower part of the lid.
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Thick, red, raised eyelid scars are not normal after 5 weeks
Of course, you are understandably anxious, and may not be describing things quite accurately, but if your scars are as prominent as they sound, then there is a problem. Hypertrophic scars or keloids are almost unheard of in the eyelids, so I am not sure what to suggest, but definitely talk to your doctor.
While all patients scar differently, most upper eyelid scars heal very well. In general scars in most places tend to look fairly red and inflammed at about the 6-8 week mark, and continue to mature for up to a year, somtimes longer. I would tell you to wait several months before considering doing anything else. The thickness of the scars should also improve during this time. It should not make much of a difference that this is your second eyelid surgery.
At six weeks, scars are at their worst
Eyelid and skin incision scars go through a healing process. At six weeks, incision are at their worst in appearance so I wouldnt worry. I would avoid the sun because that tends to prolong the healing. If you have had a cut before you would know that the instant you had a cut, it didn't look that bad. However over a couple days it got red, left a scab and then started healing. These incisions should resolve without a problem within the next several months. This is still in the early stage of the game.
At this point in time the incisions should still be visisble...however the desciption of thickened may be more than expected. You should go beck to see your physician regarding this matter
5 Weeks Is Early to Worry But You Can Start Treating Eyelid Crease Scarring
I am sorry to learn about your concerns. After 5 weeks I would still expect your being able notice the eyelid crease incision ( I assume your are speaking about an upper eyelid surgery.) Everyone is different in the amount of time that this takes to heal. If the area is raised you can very gently massage the area 2-3 x/ day for 5 minutes. Please also speak to your cosmetic surgeon about creams that can be massaged into the area to improve the line faster.
As an Ocular Plastic Surgeon I am routinely asked to improve incision lines and contours of the eyelid after blepharoplasty. Some patients need to have the scar line removed and resutured; others can benefit from laser skin resurfacing; but more often than not watchful waiting is all that is necessary.
Lower eyelid surgery is accomplished at my office without any skin incision at all. I gently remove the fullness (fatty tissue ) from the inside of the eyelid. I then tighten the skin with CO2 (carbon dioxide) laser resurfacing. NO stitches, NO skin Incision and NO scalpel.
Being your second eyelid surgery should not make a difference in the healing of the skin unless you had a lot of scar tissue from the prior procedure.
Eyelid scars after blepharoplasty - Los Angeles
Blepharoplasty scars can be improved using laser, scar creams, and gentle massage. Most will resolve quite well after surgery. Raffy Karamanoukian Los Angeles
Web reference: http://www.surgery90210.com/face/44/eyelid-surgery.aspx
Scars Usually Takes 12-18 Months To Reach Maximum Recovery Following Blepharoplasty
Anytime an incision is made, scarring will occur to some degree. The eyelid is an area where scarring is usually minimal and the scars are well hidden in this location. It usually takes 12 to 18 months for scars to reach there 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 lubricated with ointment can minimize indentations in the scar. Avoidance of infection can minimize hypertrophic scarring and spread of the scars.
Massage and rarely steroid injections may be helpful when hypertrophic scarring occurs. Unfortunately, after 18 months, the option that would most likely be effective is scar revision. Under these circumstances, a small excision with re-closure could be performed under local anesthesia. This would hopefully correct your problems and give you the result you’ve been looking for. For superficial scarring, dermabrasion or laser resurfacing may adequately correct the problem.
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.