Bletharplasty Scar Past Eyebrow? Isn't It Supposed to Be in the Crease?

It is hard to say without photos.  What you are describing sounds like a very common technique.  Plastic Surgeons try and hide scars in lines that patients normally have.  It is very early in the post operative course to draw conclusions.  Please let your surgeon know your thoughts.

It is way to early after surgery for you to worry about asymmetry. There is significant swelling in the first two weeks after surgery, and sometimes even longer than that. Furthermore, surgical scar will evolve and soften over a period of months. I would not consider revision surgery on anyone until the 3 month post operative visit, and sometimes even longer than that. Scars can mature for up to a year after surgery. Please be patient with your body and let it heal.

What you are describing is what is called the "Pastorek Modification".  This technique of upper blepharoplasty is very common and extends the incision a little bit beyond the eyelid crease into the "crow's foot region". This modification, I find, yields better results because it allows the surgeon to also remove hanging skin to the side of the eye or lateral hooding.  The incision or scar should heal imperceptibly although at first it will appear slightly red and raised (for up to 6 weeks).  It is easily covered with makeup during this healing.   As far as your concerns regarding crooked sutures, keloids, and extra wrinkles, 1 week post blepharoplasty is too early to judge these issues. Keloids do not generally develop this early and usually not at all in upper eyelids.  Swelling and preexisting eye asymmetries can usually account for subtle differences in the way the eyes look. Give it time and voice your concerns to your surgeon. 

In cosmetic surgery we get some of best healing from upper eyelid incisions and the majority are very difficult to see, even without makeup. We usually think of them as a safe bet as we consider the healing risk. The incision falls in the lid crease, but past the corner of the lid will extend upward about 10 mm.

At one week postop, irregularities In the scar line may be attributable to swelling and early healing. Your sutures should have been removed before this point and it is common to have small bumps along the suture line. These are not keloids, which are tumor like masses produced when the skin is breached and are often of familial origin. Wrinkles and crepey appearing skin do not suddenly arise after blepharoplasty so you may want to take a good look at your preop photos. Often, perceptions change after surgery. Continue to followup with your plastic surgeon through the healing process and speedy recovery!

It is way too early to assess your results. Your sutures may still be in place. It will take close to 3 months for you to see your final results. There are no pictures posted on which anyone can base intelligent comments. Follow closely with your surgeon and follow directions. Very likely you will begin to see the improvement you had discussed with your surgeon pre-operatively in the next several weeks.

 

While it is difficult to fully comment without being able to see the result in photos or in person, it is still VERY early in the healing process and most scars will soften and the wrinkled appearance disappear. There is likely some swelling that is also causing some mild distortion of the incision. The best recommendation is to discuss your concerns with your surgeon and keep open communication with her/him.