1.5 years post-op - revision blepharoplasty, brow lift or both? (Photos)

Question

I had blepharoplasty 1.5 years ago. It’s left me with a thick lumpy scar and did not address my right eyebrow ptosis that is now worse. What happened to form such a scar and what is best to move forward, revision and brow lift or just brow lift?

C. Blake Perry, MD · Answer

Scar revision is certainly an option that could also remove any excess skin. Blepharoplasty surgery will not address any brow issues. Neurotoxin or browlifting procedures would be good options but an in person consultation is needed.

Kenneth D. Steinsapir, MD · Answer

A forehead lift will raise the eyebrows. This will further skeletonize the appearance of the eyes. It will make you look older. What you need is a repair of the upper eyelid ptosis and reconstruction of your upper eyelid fold. Sadly you had upper eyelid surgery that did not address your preexisting upper eyelid ptosis. Success of reconstructing the upper eyelid folds and lowering the upper eyelid crease depends on what has been left in the upper eyelids, For that reason, a very detailed examination is needed to assess what has been left for resources in the eyelid. Addressing these issues will help make your eyes look softer and better. Your eyes can be your best feature.

Zoran Potparic, MD · Answer

Some patients develop thicker, wider scars after upper blepharoplasty. That is very likely individual. Revision of the scar should be my first choice. I am not sure that brow lift is needed. It may be best to do a Botox and see how do you like the new forehead/brow look, before committing yourself to surgery. Hope this helps.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

thanks for your question. For me, the main problem is your brow asymmetry. We see this very often. The higher your brow is on one side the more uneven your eyelids look. This doesn't explain the lumpy scar but sadly sometimes this is the result of surgery. There are a number of strategies to try and improve this including revision surgery, but also silicone gel and non-invasive techniques.

Me, a good place to start with your Brown would be to try some Botox for the highbrow and even try some Botox underneath for the lowbrow. These two in combination can give you a more symmetrical brow which may save you the trouble of having a surgical solution.

Hope that helps. Best wishes, Adam Goodwin.

PS, I have a whole YouTube channel based on plastic surgery, questions like these. Feel free to have a look. Rather unsurprisingly it's called Adam goodwin surgery.

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment regarding the outcome of a plastic surgery procedure we always need to see a complete set of proper before and after pictures. If you don’t have before, and after pictures, then contact your surgeon and ask them to forward the pictures they took.
Without seeing your before pictures it’s hard to make a quality assessment. We need to know where your initial upper eyelid fold was located, and if this was altered during the first procedure. If more skin is taken out of your upper eyelid, you may not be able to close your eyes if you add a brow lift as well.
I suggest getting in person second opinion, consultations from highly experienced plastic surgeons, facial plastic surgeons, or ocular plastic surgeons in your community who have a proven track record.
For a second opinion, consultations always come prepared to bringing with you a complete set of before, and after pictures, a copy of your operative report as well as your consultation and follow up notes.
Ask your previous provider for your medical record, including all before and after pictures.
Best,
Mats Hagstrom, MD

1.5 years post-op - revision blepharoplasty, brow lift or both? (Photos)

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