9 months post upper-blepharoplasty. High and visible incisions/scars! Help please (Photo)

Thank you very much for your question and for sharing photos.  I can understand your frustration regarding the visibility of your scars.  Despite these concerns, you have made significant progress in healing as well as the cosmetic appearance of your upper eyelids.  Right now the scar quality is quite good, but the post-inflammatory hyperpigmentation is making them more visible than they otherwise would be.  You may want to consider discussing a prescription for a bleaching cream like 4% Hydroquinone with your surgeon.  If the color is faded further, it will be even less visible. Best wishes.

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

Thank you for sharing your concerns and posting your photos. Although 9 months have already passed since your surgery, there can still be significant improvement in the appearance of your scar. If the final appearance is not satisfactory, laser skin resurfacing might improve the look of it. Scar revision is also an option. You should wait another 3-6 months before having any treatments performed. Good luck.

Incisions that are too high in some cases can be more visible. Fortunately scars tend to slowly resolve, although never fast enough for us. Be sure to use your sunblock. Massage may help and certain laser treatments may help reduce the appearance of the scar. Certain lasers are very good at removing the pink coloration in scars and make them a lot less apparent

From your photos, I believe your incisions were probably made too high. For now, continue with the scar cream to get the incision to fade further. However, I feel you may ultimately need a scar revision to hide the scar. The potential risk is removal of too much skin which could hinder eye closure. Talk to your plastic surgeon about it, or at least get a second opinion from someone with perhaps more experience in eyelid surgery. I wish you the best!

It appears that your incision is not exactly in the upper eyelid crease as well as you have had wound dehiscence. Also, since you have a darker complexion, usually it takes much longer for the scar to look less noticeable. I would recommend to start having microneedling with PRP and radiofrequency resurfacing. You will need multiple treatments but it will make the area much better.  

Hello! Thanks for submitting the photo.While your scars are visible now, I think they will fade a lot.It takes 6-9 months for this. The area outside the lid on the boney part of the orbit is always visible but necessary to do to get that skin out. I would recommend the "primer" type of eyeshadows that are available-- very good coverage and matte, and blendable with your eye shadows-- stay positive-- Warm Regards,

While it has already been 9 (long) months, you will continue to see improvements in the next 3 months. Anytime we make an incision, there are microscopic and cellular changes that slowly take place over the course of a year. If you look at the incisions every day, you will drive yourself nuts, but if you commit to waiting another 3 months, you'll notice a big improvement. At the one year mark, you can decide if makeup is enough to cover it up, or if laser treatments would be a better option. Good luck and be patient  :)

Dear MelissaThankyou for your question and photos. I'm sorry you have the scar situation I see, but they may still improve with time; while they cannot be removed, there are a couple of things which might help once full healing has occurred, and if you have seen improvement with the scar cream, I would continue that for another month ir so. After that length of time, treatment using the Fraxel laser has been shown to "condition" scars and build up collagen in them, which really helps sunken or indented scars, and the lateral upper lid contour might profit from injection of some "fillers", like Juvaderm, or with injection of some of your fat--and this has been seen to help overlying scars in some cases. See a board-certified Plastic Surgeon for advice. Good luck! James H. Scheu,  M.D.