I have redness, bumpiness, hypertrophic scarring, scar contraction at 4.5 weeks post op. Any suggestions? (photos)

Question

Had blepharoplasty (Rt eye) & ptosis correction (Lt eye) performed ~4.5 wks ago. Now, inner corners have hypertrophic scars (steroid injections 3 days ago), redness, tightness, & mild pain. Left eyelid feels numb & swollen. Right eyelid has secondary creasing from hypertrophic scarring at inner corner. Is this normal recovery? Should I be using silicone gel sheets? Should I continue to massage my scars? Pls help. Thanks v much.

Thomas A. Mustoe, MD, FACS · Answer

Hi
there. You had a complex surgery with ptosis correction on one side and some
manipulation of the eyelid fold. Your incisions look fine for 4 weeks out. The
redness and bumpiness will subside, and usually the hypertrophic scars will
respond to the steroids, and they will also soften over time. The numbness is
normal and will fade. Silicone sheets are not practical on the eyelids, but
silicone cream (there are several on the market) would be useful. It is not
very practical to massage your scars so I would leave them alone. In spite of
your concerns now, it is likely that things will settle down nicely. Continue
to follow up with your surgeon. Good luck with the remainder of your recovery.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Sam Jejurikar, MD · Answer

It is very common for scars from blepharoplasty to look red and bumpy for several weeks after surgery. Scar massage and scar creams tend to be very effective in speeding up this process. Silicone sheets tend to be difficult to apply to your eyelids.I would discuss your concerns with your plastic surgeon to determine what his or her preferred scar management system is. Hope this helps!All the best - Sam Jejurikar, MD

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

Scar issues and prolonged swelling are not unheard of after blepharoplasty. However, at this point, you are not seeing your final result. You may need more time for the scars to flatten and lighten and for the swelling to resolve. Continue to follow your surgeon's postoperative instructions and if the issues persist, discuss the next step with your surgeon.

Francis R. Palmer, III, MD (retired) · Answer

I think you have very normal healing for 4.5 weeks following a blephroplasty.  The swelling and redness will calm down, but blephroplasty healing does take several weeks.  Follow all of your surgeon's advice for the best results.

William M. Ramsdell, MD (retired) · Answer

I think that you are going to do just fine. I cannot see on your photos what I would call a hypertrophic scar but agree with the steroid injection if for no other reason than to reduce redness and swelling. The swelling makes it difficult to comment about ptosis but I predict you will be quite pleased. All you really need is "Tincture of Time". Stick with your surgeon.

I have redness, bumpiness, hypertrophic scarring, scar contraction at 4.5 weeks post op. Any suggestions? (photos)

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