I had bilateral bleph and ptosis repair on Aug 17th with absorbable sutures. Healing was great for the first week when the left incision started to look red and become painful and swollen. The sutures appeared to be pulling out and were visible externally all along the scar. I saw my surgeon on day 9 and he thought it was fine. 2 days later the sutures were coming udone and were like pieces of dental floss hanging on my lid so I pulled them out (they were no longer tied or knotted). The next day the swelling started to decrease and I noticed little bumps along the lid. By the next day it was obvious that I have a reddish raised bump at each and every site where sutures were placed (14 total at both the entry and exit). It took 2 days to get a response from my eye surgeon's clinic because he is out of town. I saw a resident who prescribed tobradex ointment and told me to come back in a month. I am really concerned about this and I would like to know what exactly this is and what I can expect in terms of healing or long term issues. Is there anything else that should be done? Why did this happen?
Bumps at each suture entry/exit across left eyelid after blepharoplasty
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Doctor Answers 5
Answer to bumps on the eyelid following blepharoplasty?
I agree with Dr. Asaria's astute observation that you likely have milia along your incision. These bumps will likely resolve on their own or with minimal intervention. Also, the redness and swelling that you have is totally normal. It is unfortunate that you did not receive a faster response from your surgeon's office but I do not think that any harm was done. You appear to be healing well!
Thank you for your questions.
Stephen Weber MD, FACS
Two or more problems can occur after syrgery
It would appear to me that you have two or three issues here. Initially the tissues reacted to the sutures probably a result of some infection of the suture line. This was the pain and redness that you experienced. Suture removal would be indicated in my opinion.............they usually are removed in 5 or 6 days post surgery anyway. Your removing them was wise although we doctors like to be involved in these type of decisions. And the problem was reduced a lot by your removing the sutures so that was the correct move. Each of the suture sites had a red bump after the suture removal...........this represents the local infection reaction and will gradually go away and the Tobradex would have helped. Wait awhile for natural resolution to take place. Infrequently a thicker than normal scar can occur (hypertrophic) which can partly be resolved with topical application of special ointments containing some silicone. You may or may not be getting this scar. Months later have the scar evaluated as a scar excision might be indicated to get a good result if the poor scar persists. Have the sutures out within 1 week. Good luck. Milia might also coexcist but they are not usually painful or inflammed. They usually are just white cysts within the skin close to the incision and usually go away on their own. Occassionally they need to be removed in the office with a needle by your doctor.
Eyelid surgery, blepharoplasty incision line milia
These small bumps along the incision line appear to be milia. Milia are small inclusions or tiny "whiteheads" and are the most common complication related to blepharoplasty. The good news is that they should not likely cause any longterm side-effects. They often open on their own, or are easily treated by your surgeon by opening up the whiteheads with a tiny needle in the office.
-Dr. Jamil Asaria
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Eyelid Scarring After Blepharoplasty
In the immediate post-operative period, eyelid incisions tend to be lumpy, bumpy, red and raised. These scars tend to respond nicely to massage and avoidance of sun exposure. In the vast majority of cases, these incisions heal nicely and scarring is imperceptible.
It's important to be patient and maintain close contact with your plastic surgeon. Your surgeon should be able to reassure you and alleviate your anxiety.
Eyelid bumps on suture line
It is quite common to see these bumps along the incision line after surgery. Certainly they are more prominent in some patients. This has to do with the type of healing response a person has to skin injury, and there is a great deal of variability. In the vast majority of patients these bumps go away within 3 months of the procedure. You are just starting the peak time for scar generation, so expect the bumps to stay for a few more months. If they are still present after three months, I would urge you to see your eyelid surgeon for further management.
Yoash R. Enzer, MD
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.