What procedure will help with canthoplasty scar reduction? (Photos)

Question

I had orbital decompression in 2021 and canthoplasty in 05/2024. I was told the scar area overlapped, so it may not heal as nicely. Currently it is textured and hyperpigmented. I've been using hydroquinone 4% for 2 months which helped somewhat. What are non-surgical options for improvement? I'd also like to know budget-oriented options in addition to the gold standard options. Thanks so much!

Tanya T. Khan, MD · Answer

Hello, some pigmented skin types take a bit longer for pigmentation issues to resolve at the scar. With that said, being almost 1.5 years out, you can consider doing some skin retexturizing with laser resurfacing (such as the Moxi laser) or a series of chemical peels. Also sun protection is so important to prevent further hyperpigmentation. Please see an experienced oculofacial plastic surgeon for best results with your eyelids.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Hello, and thank you for sharing your experience. I’m really sorry you’re going through this—feeling regret after a cosmetic procedure is more common than you think, and it’s completely understandable to want the scar to look more refined.

At 9 months post-op, the scar is still considered in the active remodeling phase, which is why you’re seeing changes in color, texture, and slight widening. The combination of pinkness, shininess, and indentation suggests a mix of surface irregularity and deeper tethering under the skin.

Some treatments that commonly help improve this type of scar include:

Silicone therapy (gel or sheets) to gradually soften and flatten pink, shiny scars.

Laser treatments like vascular lasers or fractional resurfacing to address both redness and texture.

Microneedling to stimulate collagen remodeling and help with the indent.

Steroid or 5-FU injections if there is any raised or firm scar component.

Subcision for deeper tethering that creates indentation.

Topical retinoids to encourage collagen renewal and gentle resurfacing over time.

It often takes a combination approach and a bit more time for scars in the inner eye area to settle, but many patients do see meaningful improvements. What you’re experiencing now doesn’t mean the scar will stay this way permanently—there are solid options that can help it look more blended and less noticeable.

What procedure will help with canthoplasty scar reduction? (Photos)

Thank you for describing your situation so clearly. Scars in the lateral canthus area can be especially challenging because the skin is thin and previous surgeries—like orbital decompression—can affect how tissue heals. The hyperpigmentation and texturing you’re noticing are common concerns after overlapping incisions.

Non-surgical options that tend to help include:

Fractional laser resurfacing (gold standard) to smooth the texture and stimulate new collagen.

Vascular laser or IPL if redness or discoloration is still contributing to the appearance.

Microneedling as a more budget-friendly option that still improves texture and mild indented scarring.

Chemical peels (light to medium depth) to help with hyperpigmentation, especially when used cautiously around the eyes.

Topical retinoids for long-term collagen remodeling and pigment regulation.

Hydroquinone cycling or alternative lightening agents to maintain pigment control without overusing HQ.

For cost-conscious paths, microneedling, retinoids, and pigment-targeting topicals tend to be the most affordable and still effective. Laser-based treatments offer the most dramatic results but usually come at a higher price point.

Even though previous surgeries can affect healing, many patients see significant softening of texture and improvement in color over time with the right combination of treatments.

What procedure will help with canthoplasty scar reduction? (Photos)

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