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Thick Scar and Ridge After Blepharoplasty

asked 3 years ago by Aisling in Ireland
Latest answer by William Portuese, MD
Question viewed 7,386 times

I am desperate to know what to do. Seven weeks ago, I had a bilateral upper blepharoplasty. The plastic surgeon cut not only my eyelids but right out onto my face by more than a centimetre, above the corner of my eye, extending diagonally towards my brow. This has left me with two ugly thick scar lines which make me look like a clown. The edges of the cut are not joined tightly, particularly on the right side of my face, and I have a thick open ridge which is so ugly. I feel like a freak. I don't know what to ask for or what can be done to improve this.

13 answers to Thick Scar and Ridge After Blepharoplasty

Cortisone shots may help

As far as the incision on the upper eyelids, the incision on the upper lid blepharoplasty must extend laterally and outward past the eyebrow, to totally encompass the lateral sagging of skin in that area. The incision only goes out as far as the excess skin is present. If the incision stops short, there will be an excess pleat or dog ear laterally out in the crow’s-feet area. The incision is usually blended in the crow’s-feet and is nearly inconspicuous after it is... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Time will help this issue.

Dear Aisling This incision is there so that the surgeon could remove more of your upper eyelid hood. Unfortunately unlike the reset of the upper eyelid scar, which is hidden in the eyelid fold, This part is out there for the world to see. The most important thing to understand is that with several more months of healing this issue will be significantly less conspicuous. I often see patients shortly have upper eyelid surgery where for one reason or another, their blepharoplasty sutures... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

IPL and lasers can improve scars, but surgical scar revision is sometimes needed

Dear Aisling, Your incisions seem to be following a normal crows feet line. Perhaps he extended the incision in order to remove excess skin in this area. In any event, the scar is still early in healing. The redness can be improved with an intense pulsed laser (IPL) treatment program. In addition, in a few months, fractional CO2 or erbium laser treatments may also help to refine the scar. If the scar remains thick despite these treatment options, the scar may need to be revised... more

Joseph M. Perlman, MD
Houston Plastic Surgeon

doctorperlman.com

Time will heal, but 5FU may help

The other surgeons all have great suggestions about being patient with the healing process, using silicone oil scar fading treatments, considering laser treatment, and down the line considering a scar revision if necessary. There is another option to treat the red, thickened scar tissue (which at a microscopic level is very metabolically active fibroblast scar tissue). 5-flurouracil is a drug that can arrest the activity of scar tissue. It is technically a chemotherapy drug, but is... more

Tanuj Nakra, MD
Austin Oculoplastic Surgeon

Scar maturation takes 6-12 months

It does take 6-12 months for the red color to fade from an incisional scar. Still based on location I believe that your incision may be slightly visible and may require camouflage make up. Some surgeons will extend the blepharoplasty incision over the orbital rim to obtain maximum tightening of redundant skin while other experienced surgeons avoid doing this for most patients unless there is a significant amount of lateral canthal hooding.

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon

Upper lid incsions heal very well. best results take at least 3 months

The upper lid incisions heal very well but for some it requires 3-6 months to look its best. I would suggest speaking with your surgeon about your concerns and being patient with progress.

Amir Moradi, MD
San Diego Facial Plastic Surgeon

Blepharoplasty redness will improve with time

While the redness of the scar can be expected to improve with time, Pulsed light treatments to scar ridge may help speed up the process. At 7 weeks post op, it is very conceivable that this may benefit you.

Richard Gentile, MD
Cleveland Facial Plastic Surgeon

www.facialplastics.org

It will improve with time.

Your scar will likely improve with time. However, you will likely require a scar revision to achieve the best results. I agree that massage and time will help. Your scar is not longer than usual. However, it i does take a fairly acute turn laterally. In the mean time, it may also help to have some Botox injected in the lateral orbicularis muscle to help relax the area and slight elevate the lateral brow. This may help the area heal smoother and lifting the brow will less the skin... more

David Shafer, MD
New York Plastic Surgeon

In the meantime, you can cover Blepharoplasty scars up

I agree indeed that with time this is likely to get a lot better, but that it may not improve to your liking and a revision could be done. I would give it another month before you consider the revision. You may be so happy with the progress you will be patient even much longer. That said, there are some great concealers which can help you. as you wait. Dermablend comes to mind, but you can go to a good esthetician to get some tips on this. We have seen this do wonders for ones peace of... more

Patrick Byrne, MD
Baltimore Facial Plastic Surgeon

Be patient with healing ridges after Blepharoplasty

You need to be a bit patient with this. Presently, you are at a stage of healing that is the most unsightly. Your raised areas are called healing ridges due to the ingrowth of blood supply and scar tissue. This causes it to be red, rasised, lumpy, and bumpy. This will all sort itself with time (after a few months). You may ask for some scar cream like Mederma or Post Balm. Ask your doctor for massage tips, and keep it out of the sun. Cover makeup will help to conceal it while you heal.... more

Scott E. Kasden, MD
Dallas Plastic Surgeon

Massage and topical 1% hydrocortisone cream will definitely help

For now, I would vigorously massage the scar firmly against the underlying bone 2-3 times a day. I would also apply 1% Hydrocortisone cream to the scar 3 times a day for 2-3 eweeks and then stop. The scar will definitely imporove and become white after 4-6 months. At 6 months, if the scar is noticeable and depresssed, it can easily be revised under local anesthesia. If over the next 3-4 weeks the scar continues to get redder and more raised then you may be developing a hypertrophic scar... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

You just need a little scar revision.

To Aisling, Hi! Your scar is not excessively long. It is noticeable because there is some skin overhang, and there is a little separation of the edges. Wait a few more weeks. I am sure your surgeon will then revise these scars under local anesthesia. I predict a few months after that, you will hardly see them. You will be fine!

George J. Beraka, MD
Manhattan Plastic Surgeon

Scar after upper blepharoplasty

Extending the upper blepharoplasty incision outwards towards the brow tail is common practice to improve "lateral hooding" of skin at the outside edge of the lids. It appears that the incision line has seperated a little bit in your case. This will improve quite a bit with time but it may not be to your liking at the end. If after about 4 months or so the scar is still unsatisfactory, you may want to discuss a little revision procedure which should be easy to under local anesthesia... more