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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.

Doctor Answers (19)

Firm nodule in blepharoplasty scar

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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.

Chicago Plastic Surgeon
5.0 out of 5 stars 51 reviews

You have suture cyst

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 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
5.0 out of 5 stars 65 reviews

Upper Bleph Scar, Consider Kenalog

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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
5.0 out of 5 stars 23 reviews

By 15 weeks, blepharoplasty scar should be quiet

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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 type of procedure is generally so minor that it does not qualify as a revisional procedure. There is typically very little down time. The red bulge is numbed and excised. When these cysts are quiet, the skin can be just cut open with a small needle and the cyst expressed. Contact you surgeon and ask for the nodule to be removed. Alternatively, an oculoplastic surgeon in your area can address this issue. Find such a specialist in you area by looking on the web site.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 19 reviews

Bleph Scar Bulge

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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.

Red bump 16 weeks after blepharoplasty is unusual

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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.

Upper Blepharoplasty Scar Healing Problem

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Although most scars settle in about 12-15 weeks on the upper eyelid there are times when they can be more prominent.  Genetics play a role.  However by the description given these appear to be small cysts that have formed- this is common on the eyelid.  If one turns red and increases in size it is possible that it is infected- time to visit your surgeon.  Although many will ultimately go away, some even if not infected may require removal.  Other possible causes include retained stitch material.  There are some suturing techniques that result in less cyst formation than others.

George Volpe, MD
Boston Plastic Surgeon
5.0 out of 5 stars 5 reviews

Bump on upper lid

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You either gave a cyst or an unusually thick scar at that spot.  If you were my patient I would proceed with a scar revision.  No need to wait any longer.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 12 reviews

Consult with Your Surgeon as it Looks Like You May Have an Inclusion Cyst that May Require Surgical Excision

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After three months, most upper eyelid incisions have minimal redness. The bump on your upper eyelid suggests the possibility of hypertrophic scarring or an inclusion cyst. An inclusion cyst can occur when the outer layer of skin is turned inside out and as a result, grows inward forming a cyst. It can also occur when retained suture remnants are left in place. Infection and resultant inflammation can create the redness and tenderness that you describe. Bumps like this can also be seen with hypertrophic scarring. Sometimes, chronic inflammation can create a raised tender scar,

Early in the post-operative period we generally recommend massage. However, at this point surgical excision might be considered. You should consult your plastic surgeon for his opinion regarding this eyelid lesion.

Incisions on upper lids undergo lumpy-bumpy phase

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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.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

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.