Blepharoplasty scar revision removed too much skin and left me without an eyelid crease on outer corner of eye

Question

I had a blepharoplasty (upper eyelids) that left me with a visible scar on the outer corner of my left eye. I went back to the surgeon for a scar revision, and he ended up removing the entire outer portion of my eyelid crease, while leaving a more obvious scar. Now my left eyelid (red arrow in photo) is a completely different shape than my right lid. Very asymmetrical. Can a skin graft or fat graft fix this? There's not enough skin on my eyelid currently to make a new crease. I'm 30 years old.

Kenneth D. Steinsapir, MD · Answer

The amount of skin present or absent does not determine the crease. Likely you have more than enough skin for reconstructing a crease. The issue is that one need to actually understand what is involved in this. A crease is a strong attachment between the skin, the orbicularis oculi muscle and the levator aponeurosis that is the tendon that raises the eyelid. Your creases are too high. You likely have the fat you need for a fold but it is matted down in scar. These are details that are determined at the time of a detailed, in person visit. Please understand that grafted fat and skin grafts are are likely to further harm your appearance. There are very few surgeons like myself who are expert in these issues.

Blepharoplasty scar revision removed too much skin and left me without an eyelid crease on outer corner of eye

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Blepharoplasty scar revision removed too much skin and left me without an eyelid crease on outer corner of eye

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