I have scars on upper lids 6 months after blepharoplasty. Is there something I can do to help them heal? (photos)

Question

Have gone back to original doc three times and have tried laser treatment and kenalog injections. Nothing has worked.

Andrew Campbell, MD · Answer

I think the treatment you have received so far seems appropriate. The scars are not ideal, but far from horrible. You can try additional laser treatments and / or injections, but if the scar is still a problem after a year, a scar revision could be considered.Andrew Campbell, M.D.Facial Rejuvenation Specialist
Quintessa Aesthetic Centers

Dallas Homas, MD · Answer

Hello.  I recommend that you give it some more time.  Your scars don't look too bad, and the healing process is still going on.  You can try massaging the scars gently each day with a soothing lotion.  See what they look like one year post-operatively.  If they are still too thick, you could consider an intervention like a scar revision.  Good luck!

Harold J. Kaplan, MD · Answer

Hi Tattered.  In part it depends on what you don't like about the scars.  Is it the fact that you can still feel them (raised and hard) or is it because even though they are flat, you can still see them.  Raised scars should be treated conservatively with Kenalog or another steroid.  Flat scars may be treated with fractional resurfacing and we do prefer to do this while the scars are still healing (first 6 months).  The resurfacing would be a light one as the skin is very delicate in this area, but it may be able to blend in the scar if it's flat but is inconsistent in color with the surrounding tissue.

John R. Burroughs, MD · Answer

Upper eyelid blepharoplasty incisions usually heal very well.  Rarely they can take up to a year to get their best appearance.  Although, it is usually closer to the 6 months where you are at.  Kenalog/5FU injections can help up to 6 mos out as well as topical prescribed steroids very sparingly applied to the raised hypertrophic areas of scarring.  Very rarely, you can resect the old scar and start with a new one, which is probably less than 1: 2-3K cases in my experience.  Don't give up as it can get better.  Best regards.

Earl Gage, MD, FACS · Answer

The upper eyelid skin is very thin and often makes a very thin, inconspicuous scar. At 6 months after surgery, I would advise you to be patient for a little longer as scars tend to soften and improve for up to 1 year after surgery. You might also consider massaging the scars each day with a mild facial moisturizing cream. If after 1 year the scars still remain thick, then excision of the scar and meticulous reclosure may be the best option. Be aware, however, that your body may be biologically "wired" to make a thick scar, and it may heal the same way again.

Mark Taylor, MD · Answer

I have performed over 2000 upper eyelid blepharoplasties.  Occasionally someone will heal with a thickened or rough scar, something that is unique to certain individuals and the way their body (skin) heals.  I have found the Fraxel Restore 1550 nm laser to be very helpful in blending and softening these scars.  Multiple treatments are often necessary.  If the scars are keloidal or markedly hypertrophic, I will rarely use Kenalog injections.   Skin Medical scar gel is also helpful as are silicon gels used immediately following suture removal.

Devinder S. Mangat, MD, FACS (retired) · Answer

Scars in the upper eyelids after Blepharoplasty will rarely respond to Kenalog injections or laser treatments because of the very thin skin.  The only effective treatment is to remove the old scar and meticulously close the incision to get a better scar. Using subcuticular suture is frequently helpful to get a more favorable scar.  This can easily be done under local Anesthesia.  The only caution is that the surgeon needs to make sure there is enough skin in the upper eyelids so that you don’t get dry eye issues later.  In looking at your one photograph it appears you do have enough skin but a live consultation would be necessary.

I have scars on upper lids 6 months after blepharoplasty. Is there something I can do to help them heal? (photos)

Answers (7)

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