What could have caused holes after eyelid surgery? 13 month post op (photos)

Question

I had Asian eyelid surgery and it's been 13 months post op. There are a lot of suture holes on my eyelids - I'm unable to wear makeup because it gets into these holes which defeats the purpose of my eyelid surgery. The doctor said he used dissolvable internal sutures which should take a few months to dissolve and help fixate my crease. For 3-9 months, I asked when these holes will close up. He kept saying they will close but it's been over a year. Why are these holes here?

Eric M. Joseph, MD · Answer

The location and pattern of these holes seem to coincide with where your sutures were placed in your skin. Frankly, this is an unusual situation. Without examining you, I suspect that since this is likely all skin deep, a scar revision may be helpful for you. Please consider discussing this with your surgeon or consider meeting with an oculoplastic surgeon for definitive advice. Thank you so much for this question. Sincerely, Dr. Joseph

Dana Goldberg, MD · Answer

My opinion is that these are areas where the suture under the skin was close enough to the surface that it caused a permanent pucker. You could try Laser resurfacing for this area, however, a simple superficial scar revision with external stitches that are removed within one week should solve the problem.

Given how close I see some of your eyebrow hairs, I suppose it is possible that these could be residual skin or hair follicles, but that is less likely. The solution would be similar in any case.

Kyle Kimura, MD · Answer

These marks are a bit interesting as normally track marks from suture show as lines rather than small holes. However, the concept is similar in that there has been some mild scarring from the sutures after surgery. I would have expected this to heal at this point if it was going to do so on its own. I think there are many options to consider based on how bothersome these marks are. Scar revision is an option, however there is no guarantee that the tissue doesn't heal with the same marks. A very gentle laser or microneedling treatment is another option, though you must be very careful around the eyes themselves. Hope this helps and best of luck!
Kyle Kimura, MDFacial Plastic and Reconstructive Surgery

Gary M. Horndeski, MD · Answer

This appears to be related to the sutures placed internally.  You will need the scars revised.

Best Wishes,

Gary Horndeski, M.D.

Kenneth D. Steinsapir, MD · Answer

When suture is left in place for more than 5 or 6 days, an epitheialized lining can develop in the path of the suture. The keratinizing skin lining these tubes make keratin and this material oxidized to look black.  Generally this need to be excised to address the issue. Speaking with your surgeon about this is a good recommendation.

What could have caused holes after eyelid surgery? 13 month post op (photos)

Answers (7)

Answer: Revision

Answer: Revision

Answer: Agree that these are suture tracks.

Answer: Agree that these are suture tracks.

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Everything you need to know about Eyelid Surgery

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What could have caused holes after eyelid surgery? 13 month post op (photos)

Answers (7)

Answer: Revision

Answer: Revision

Answer: Agree that these are suture tracks.

Answer: Agree that these are suture tracks.

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.