Blepharoplasty Scars?

Are eye lid incisions alwasys made in the crease of the eyelid? Mine are in the shape of a curve that goes up to my brow area. I had a blepharoplasty with a brow pexy. Scars are very high & eyelids are wrinkled. Eye lids were smooth before surgery. My right eyelid feels very tight and was extremely droopy for months after surgery & feels weird when I animate. I will not wear eye shadow as it accentuate's the wrinkles & scars. My eyes look hollow & distorted.Suffer from dry eyes. How to fix?

Doctor Answers 7

Poorly designed upper blepharoplasty incision.

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Dear Cerro

You probably did not need us to tell you that.  Your upper blepharoplasty result is suboptimal.  The photos show a very high incision without anchor fixation.  The scar extending laterally is atypical.  However, without a personal examination, it is very difficult to be more definitive than this.  There are views that if they were shown in the photos would make it easier to be more definitive but still it does not replace a personal examination.  It is very difficult to lower the crease.  However the skin below the crease to the lash needs to be cleaned up.  The tendon holding the eyelids up may have been weakened by surgery or the swelling associated with the surgery.  This does create the potential opportunity to improve the surgical result by correcting the ptosis and cleaning the excess eyelid skin on the platform up.  I would recommend allowing this to heal 6 to 12 months before entertaining revisional surgery.  I would not recommend allowing the original surgeon to attempt the revisional surgery.  While he may have had a very good reason for designing the eyelid surgery this way, it does not foster confidence that a revisional surgery with the same surgeon will be satisfactory.  Seek second opinions with oculoplastic surgeons who direct their practice toward fixing unsatisfactory prior eyelid surgery.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Upper eyelid surgery scars typically placed in the eyelid creases

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 Yes, the upper eyelid surgery incisions are typically placed in the upper eyelid creases to make them less visible.  I'm not certain why your plastic and cosnmetic surgeon would have done otherwise and should be something that you would need to discuss with him/her. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews


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Blepharoplasty scars should be placed in your upper eyelid crease. Your scars have definitely been placed in a suboptimal position. If you are having dry eye symptoms, you definitely should consult with your local eye doctor or oculoplastic surgeon.

Roger Bassin, MD
Orlando Oculoplastic Surgeon
4.7 out of 5 stars 95 reviews

Blepharoplasty incision

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Upper blepharoplasty incisions are usually designed to fall along the natural eyelid crease. Persistent problems with muscle movement, dry eyes and excess skin deserve a second opinion. Most importantly, keep to an eye lubrication regimen so as not to suffer from any permanent vision problems.

Kristin Egan, MD
Manhattan Beach Facial Plastic Surgeon


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Thanks for posting pictures as it is helpful in answering your question.  However, it is not obvious which are pre or post-op.  Is the first picture posted (the sideways one) a pre-op or a post-op picture.  If it is a post op pic, then you may need an evaluation for a secondary surgery as there seems to still be excess skin.  As for placement of the incisions, I agree that the incision typically goes in the natural crease of the eyelid.  Eyelid incisions usually heal exceptionally well.  If you do have concerns, you should discuss them with your initial surgeon and if you are not satisfied, then seek a second opinion.


Good luck.  

Upper lid scars after blepharoplasty

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The upper lid scar can vary in upper lid rejuvenation. However, the scar most always will follow the fold in the lid about 9mm or so from the lash line, and then extend about 10mm past the outside corner of the eye. The scar from lid surgery is very well concealed and most have very few complaints with appearance or cosmetics. Hollow look, distortion, dry eyes, wrinkles, all deserve a second opinion and perhaps a third to set you in the right direction.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews


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Typically a blepharoplasty incision will go in the eyelid crease,b ut it can migrate a bit up or down.  If you have persistent dry eye, you should  be checked out.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.