Would Blepharoplasty Result in Scar Tissue Due to a Young Age?

Hello everyone. A recent visit to a plastic surgeon resulted in him telling me that if I had Blepharoplasty, the risk of excess scar tissue is a definite possibility.

I would like to get as many opinions as possible, but am very apprehensive about dermal fillers due to the horror stories I have heard about them (though I do know it's not the product, rather the injector!)

Please let me know what my best option(s) is/are for my tear troughs. Thank you, and take care!

Doctor Answers 14

Would Blepharoplasty result in scar tissue due to a young age?

Hi Eth,

Again, first I would recommend leaving well enough alone, enjoy your youthful uncommon beauty. Scarring and scar tissue are not the problems with blepharoplasty for you, you just do not need surgery.

If you do anything, find the best, most experienced injector of the lower eyelid area, and have conservative treatment with Restylane. My best advice is leave those beautiful eyes of yours alone!

Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Age and surgery

I hate to differ with the two prior physicians, but I hate using fillers for the tear troughs in the lower lids. First of all, your photos are poor for evaluating your problem, there are many young people who have prominent fat pockets in their lower lids and they can be easily and permanently taken care of with a small surgery where there is no external incision.

Fillers need to be constantly re-injected into the lower lid area and can give terrible results.

Seek a consultation IN PERSON, with a qualified Plastic Surgical professional and let them evaluate your issue in person.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Tear trough treatments

There is absolutely no way you should or could have a safe lower lid blepharoplasty. You already have some scleral show and your risk of worsening it is huge. Your tear troughs need Restylane and it should be done by an experienced physician injector. Please don't let anyone talk you into a bleph.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Options for tear troughs

  • We do not recommend injections into the tear troughs. There have been multiple complications with this procedure whereby patients look pretty puffy for years on end because the dermal filler has been injected into the orbital fat.
  • It is important to identify what is causing the tear trough.
  • If there is a double bubble effect created from the fat in the lower lids a simple conservative fat removal can be done through a transconjunctival approach to give a nice new natural contour. This procedure is termed, lower lid blepharoplasty.
  • Fat repositioning is also an option to fill in the tear troughs.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Lower eyelid surgery can be tricky

Dear Etherealism,

As you can see your question created a lot of answers because lower lid surgery can be tricky! I would not recommend it for you for all the reasons mentioned above.

Fat injection to fill the tear troughs can be "uneven" as the fat "heals in spotty". A "trial run" with a colorless filler (Juvederm, Prevelle) by an experienced Surgeon maybe your best bet.

On the other hand youth is your best friend at this time and enjoy it as long as you can. Many opportunities for cosmetic surgery will come up early enough!

Good luck!

Guido P. Gutter, MD
Evansville Plastic Surgeon
4.9 out of 5 stars 18 reviews

Blepharoplasty scar tissue result

I would also refuse to do any eyelid surgery on you from your appearance in the posted photo. As for the tear troughs use Restylane or some other temporary fillers. Regards.

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Fillers as a trial to assess the appearance of surgical eyelid interventions

Conservative and possibly staged injection of Restylane to the lower eyelid and cheek junction is a reasonable option albeit temporary. This would allow you to determine if you like the result. You could then proceed with learning about surgical options for achieving a longer term solution.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

Filler is clearly your best option

Dear Ether

What you are hearing is the voice of caution. Yes you have an issue: fullness in the lower eyelid and a hollow under the eyes. Your eyes are big. The risk of lower eyelid surgery damaging the muscle the holds the lower eyelids up is huge if an cut is made under your eyelashes to reposition your lower eyelid fat. You could have surgery from behind the lower eyelid to reposition this fat. However, one must always weight relative risks: The punishment must fit the crime. Until about 6 years ago, surgery was really your best option.

However, today it is filling of the lower eyelid hollow with Restylane. I recommend going onto the liquidfacelift.com website to find a qualified injector in your area. Avoid surgery as long as possible.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Fillers can stave off a blepharoplasty

A tear trough deformity is a hollowing under the eye, near the nose. There are many theories why these occur. They become obvious when fat above herniates out creating a shadow where the tear trough is. Surgically this is treated by taking some of the fat from the eyelid and moving it to the tear trough. For many patients, this hollow area can be filled with a filler such as Restylane and yield excellent results.

The good thing about dermal fillers, especially hyaluronic acid fillers is that if you don't like the result it can be dissolved with an enzyme injection, Vytrase or wait until it goes away. The eyelids are very delicate with thin skin so this treatment should be done by a very experienced physician.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 126 reviews

Restylane is great for tear troughs

I do not feel that surgery would help your tear trough unless you had some sort of an implant, which I do not suggest. On the other hand, properly injected Restylane, would help. The advantage of Restylane is that if, for some reason, you are unhappy with the result it can be completely dissolved.

Hope this is helpful.

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 24 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.