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Upper Blepharoplasty Scar Healing Problem?

I had an upper blepharoplasty done 15 weeks ago. The scars are still bumpy, and on one lid, there's a prominent red bulge. I've been massaging and using Dermatix (30 days so far), as directed by my doctor, but it doesn't seem to be getting any better. Should I be concerned at this point? I did not have dissolvable sutures.

Asked 35 months ago by NancyL in Palo Alto, California

Tags:

bump bumps

Firm nodule in blepharoplasty scar

I would agree with the comments of others made here. It is not uncommon to have an inclusion cyst along the suture line. Occasionally, these get inflammed and other times they get infected. Treatment typically consists of evacuating the cyst. Alternatively, it could be an inflammed nodule that would benefit from steroid injection. Seek the advice of your surgeon and proceed with his/her recommendations.

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

You have suture cyst

Please ask your doctor to revise the scar and to remove the cyst. This not rare but will not go away by itself. If your doctor does not want to treat this ,find another surgeon.

Kamran Khoobehi, MD

New Orleans Plastic Surgeon

ASAPS ASPS

Your surgeon needs to be more aggressive

The upper lid is the best scarring area of the body. Most patients look great even after a week. Although all scars can become reddened this usually occurs around the 4 week mark. I agree with the other surgeons that this red area is an inclusion cyst, small stitch reaction from a deeper stitch or if this has been enlarging rapidly could be a pyogenic granuloma (unlikely). Some lesions will do well with a tiny amount of steroid. Or this scar may just need a minor revision to improve it... more

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Upper Bleph Scar, Consider Kenalog

Hi Nancy, The only thing that I would add to the excellent comments of the other physicians is speaking to your surgeon about the possibility of a very dilute and very small quantity of a steroid injection (0.02-0.05 cc of Kenalog-10) directly into the scar tissue. I hope that your scar resolves quickly. Dr. P

Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon

Bleph Scar Bulge

Thanks for your question Nancy - That bulge may be an absorbable suture that is disolving. You should ask your surgeon if they used any dissolving suture (in addition to discussing your concerns about the healing). At 15 weeks your incision should be faint, thin and not red. I hope this helps.

Steven H. Williams, MD

San Francisco Plastic Surgeon

ASPS

Red bump 16 weeks after blepharoplasty is unusual

The most common cause of a red bump 16 weeks after upper blepharoplasty is a retained suture or suture abscess. Sometimes, a small piece of suture is left behind in the skin after suture removal, and this can inflame the skin and leave a red bump. Probing and removing the suture will resolve this. If the doctor used resorbable sutures under the skin, a small abscess can form around the suture and create a red bump. Your doctor can sort this out.

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Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Incisions on upper lids undergo lumpy-bumpy phase

The incisions on the upper lids tend to undergo a lumpy-bumpy phase one to three months after the surgery. All of this phase tends to settle down where the lumpy-bumpy pink incision will turn to a fine little white line hidden in the natural crease. On rare occasions, a small milia may turn into a pimple right at the incision line, and this needs to be expressed with a small needle and Q-tips.

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William Portuese, MD

Seattle Facial Plastic Surgeon

Postoperative Blepharoplasty Cyst

Swelling of the upper eyelid incision may likely represent a cyst, either from a trapped suture deep in the skin or trapped epithelium under the skin. More concerning causes for this swelling may be infection / abscess or early scarring. Most expected swelling and redness after blepharoplasty usually only lasts a short period time, and 15 weeks is unusually long. Treatment is relatively minor which may include a minor revision procedure, stab incision and drainage of fluid, antibiotics,... more

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Houtan Chaboki, MD

Washington DC Facial Plastic Surgeon

Ask Physician about Steroid injection

At 15 weeks there should be a smoother scar and this could be due to a cyst or hypertrophic scarring. Ask your doctor about some minimally invasive options such as a steroid injection to calm down the area if it is not a cyst. If it is a suture abscess the steroid injection may also help this.

Doctor's Website

Richard Gentile, MD

Cleveland Facial Plastic Surgeon

While the scar is more reddened than usual, it should resolve with time

While the scar is more reddened than usual, it should resolve with time. I have found it often responds nicely and heals quicker with treatment with a vascular laser, such as a 532 or 1064 laser that helps to lessen the redness and cause quicker scar resolution. A lot of physicians carry that type of laser in their practice.

Scott Trimas, MD

Jacksonville Facial Plastic Surgeon

This is not normal healing

At 15 weeks after upper bleph your scar should be almost invisible. You might have a cyst in the incision and you should go right back to your surgeon for an evaluation. You will almost certainly need something done to this scar. Good Luck!

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

Rule out infection and foreign body

Most of your wound length is healing well. There is only a small spot where it is inflammed. The first thing I would like to rule out is a foreign body present, e.g. portion of your suture, etc. If there is any infection, pus etc., it needs to be addressed.

Hisham Seify, MD, PhD

Los Angeles Plastic Surgeon

ASPS

Ask your doctor what he will do if it does not improve.

It is important to keep good communication with your surgeon and let him know how your healing is progressing. Massage is good, but if it doesn't seem to be improving, you will want to let him know. Time may be all you need. However, I recommend that you find out what your surgeon will do if the incision does not improve and what the time fram will be. It will help to put your mind at ease if you know what to expect.

Thomas T. Nguyen, MD

Orange County Plastic Surgeon

ASPS

Go see your surgeon

At 4 months your incisions should be completely healed and barely perceptible at this point. You may have a small seroma or other problem where you have redness. It is difficult to say without examining you. I would see your surgeon to determine what course of action may be required.

Samson Lee, MD

Seattle Facial Plastic Surgeon

By 15 weeks, blepharoplasty scar should be quiet

Dear Nancy, We don't have pictures but by this time frame, the bleph scar should be quiet even if the doctor had used absorbable stitches. Still, it is quite common to develop a small incision cyst along the bleph incision. This represents a small bit of surface skin that gets trapped below the skin surface. The skin element grows and gets walled off to form a small cyst. If you do have these, they typically do not go away on their own but require a small office procedure to remove. This... more

Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

At 15 weeks, the incision should be imperceptible

If you post a picture we may be able to give you more specific advice. However, at 15 weeks, the incisions should be close to imperceptible. Perhaps you are having a reaction to the underlying absorbable suture material or to the topical products which you are using. You should follow up with your surgeon to make sure everything is okay. Good luck.