Desperately need to fix the problem! (photos)

Question

I had ptosis surgery to my right eye, in my first surgery i only had the levator muscle elevated. I had revision surgery 6 months later to remove excess skin. In my opinion my surgeon didn't remove enough, he also only did a partial incision(with laser) on my old scar so now i am left with pinch skin in the inner corner and a big thick white scar. Am i able to have blepharoplasty to fix this issue? If so am i able to see a regular plastic surgeon or do i need to go to an oculoplastic surgeon.

Amiya Prasad, MD · Answer

In the normal population, if the eyelids are one to two
millimeters from each other, it doesn’t draw attention and is considered normal.
After reviewing your photos with your eyes open, it appears that the objective
of making the eyelid elevated and getting relative symmetry, shape and contour
appears to be achieved. When we measure a successful ptosis surgery, we measure
the height, contour, aesthetics and symmetry of the eyelids. It obvious with
your eyes looking down that there is a difference with your eyes closed but
with your eyes open, it appears that you achieved your objective and I know
that anyone who looks at your eyes would probably agree that the eyelid height
relative to the pupil is where you wanted it to be after ptosis surgery.

I think that it is best that you continue communicating with
your doctor who did the original surgery. If you’re concerned about extra skin,
your original surgeon knows whether or not that’s the case. Sometimes the folds,
variability and the appearance is not a function of excess skin but rather the
skin being attached or folding in a certain way. An example is like a non-incisional
Asian eyelid surgery where it may appear to have overlapping skin when actually
there is no extra skin, but the skin is attached in a way so that the eyelid
crease can form. A variation of this procedure is done for ptosis surgery when
it is appropriate. So my first piece of advice is that you continue
communicating with your original oculofacial plastic surgeon. This is the
doctor who knows your eye very well and I’m sure has reasons for doing the
procedure the way it was done.

In choosing revision procedures, you may want to consider
some procedures just to improve the scar quality. In our practice, we use a
material called platelet-rich plasma which is drawn from your own blood to help
scars that are very thick. We have also found this to be very helpful in
softening scars. There was no clear indication from your question as to the
time frame of where you are in the healing process. When we think of eyelid
healing whether it’s skin or muscle to take up to 6 months to a year, not just
a few months. Especially in eyelid surgery, an undesirable scar can change over
the course of a year so you may want to do some conservative options until
considering another surgery. Again, my advice is to meet with the original
doctor and discuss your options. If you don’t feel confident about the
recommendations then you can consider second opinions. I hope that was helpful,
I wish you the best of luck, and thank you for your question.

Desperately need to fix the problem! (photos)

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Desperately need to fix the problem! (photos)

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