22 days post op upper and lower blepharoplasty with canthoplexy, my scars getting worse! Any suggestions? (photo)

Question

Please help. The scars in the corner of my eyes are getting more visible and look horrible. They are also red, and with bumps. I have been massaging them for the last week and putting warm compresses on them as surgeon instructed, but they seem to be getting worse! What can I do about his, and is this bad stitching or will it get better eventually? Thank you so much for your replies.

Kenneth D. Steinsapir, MD · Answer

You are just 3 weeks out.  Things will soften and can look remarkably better over the course of 6 to 12 months.  If this were a reconstructive surgery, the ultimate result might be satisfactory.  However, for cosmetic eyelid surgery, the way the canthal surgery is healing may prove to be visually unsatisfactory in the long run.  I do not know the back ground of your surgeon but it is my opinion that canthal surgery is often very unsatisfactory.  I am often quoted as saying that canthal surgery is reconstructive surgery not cosmetic surgery.  My colleagues to not get it.  For now you need scar management.  I generally do this with 5-FU to soften the scar.  I do no recommend steroids which are also used to soften the scar because they can cause fat atrophy which can definitely be an issue.  Occasionally steroids are needed when there is a lot of inflammation but one needs to be cautious with this.  Repairing this will be complicated.  Naturally your surgeon will want to make this better.  Just beware that repairing this may be beyond the skills of your original surgeon.  Caution is advised.

Mehryar (Ray) Taban, MD, FACS · Answer

We can consider scar injection treatment to soften the scar until it fully heals (3 months or longer). It may be possible that it would need scar revision surgery. Best to see an oculoplastic specialist.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thanks for the pictures.  The scars should improve and soften with time.  It may take six months to a year before the scar matures.  Keep close follow up with your surgeon.

Chad C. Zatezalo, MD · Answer

Carina.  You are in the acute healing phase of your blepharoplasty/canthopexy.  The scars will look the worst from approx week 4 to week 6.  They are indeed inflamed and irregular.  With time they will relax and likely improve.  There are several types of medications that can be injected and a few topical treatment (silcone, steroids etc).  I would follow your surgeons recs at this point and continue to massage and make sure to keep the scars out of the sun.

Curtis Wong, MD · Answer

but you do have a bunch at the lateral end of your lower lid incision.  The other incisions remain fine lines.  What does your surgeon say about this?  If you haven't discussed with your surgeon, that is the best place to start.  But your scars do not appear alarming in your photos and it will improve and lid scars are rarely an issue.

Costas Papageorgiou, MD, FACS · Answer

Although the healing process takes several weeks and each patient has different recovery times I would be inclined to stay under close follow up by your surgeon. Coctail injections of biological agents can be helpful in the early stages of healing as they can suppress the activity of cells involved with tissue over-reaction. The eyelids are a sensitive area of the face and require subspecialised input.

22 days post op upper and lower blepharoplasty with canthoplexy, my scars getting worse! Any suggestions? (photo)

Answers (6)

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