Fillers for Blepharoplasty Scars?

After a lower Blepharoplasty, I have wide and deep scars at the outer corners of my eyes. The plastic surgeon said that any scars would blend in with my crow's feet (they don't). I already tried Fraxel Laser treatment and it seemed to make it worse. Then I read that Fraxel kills fat cells. Would a filler be beneficial?

Doctor Answers 7

Filler is great for this type of issue.

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Dear Jane

I think that you are getting advise that is very friendly to your treating plastic surgeon and perhaps not so helpful to you.

I don't have your photos. Ultimately there is no substitute for a personal consultation.

The trend with lower trancutaneous lower blepharoplasty has been to combine this procedure with some type of midface lift through an extended lower eyelid incision, or perform some type of canthopexy or canthal support procedure. Often these procedures may be incorporated into the routine performance of the lower eyelid surgery to prevent sagging of the lower eyelid after surgery. When these procedures are performed there can be some stretch back in the healing tissues contributing to the loss of tissue volume you are describing in the outer corners of your lower eyelid.

Even when these types of procedures are not performed, there can be atrophy and loss of tissue volume leading to a depressed scaring in this area. This outcome is not necessary preventable or foreseeable. A scar revision may not help this area. The problem may in part be due to a loss of skin and associated tissue volume. If the depressed scar is related to a lack of skin, cutting out more tissue may or may not help the problem.

I have found that using a small amount of Restylane to build up support for the skin in this area is very helpful. I would encourage you to find a cosmetic dermatologist who does a lot of facial fillers to help you with this issue. Don't rush back to your plastic surgeon for revisional surgery.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Fillers may only benefit depressed scars.

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The visibilty of the scar can be improved if it is depressed with the use of a dermal filler. If skin texture changes are the most undesirable characteristics then anotherr solution may be ablative fractional therapy such as the DeepFX or Pearly or Sciton tunable resurfacing laser. We have found all three to be helpful with unfavorable scars in our office.

Richard D. Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 45 reviews

Filler is okay but maybe a revision of the skin is better

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Why you have wide and deep skin scars after a blepharoplasty is unclear. Done correctly the scars should be no longer than a centimeter and a fine line that falls into natural lines.

It scar is wide then filler won't help. If it's deep than it will by why not fix both issues. I would consider revision the scar with appropriate repair and kill two birds with one stone.

I agree with Dr Kasden - Scar revision may be needed

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Sometimes the lateral portion of the lower lid scar will be a little thicker than the medial because the skin is thicker as you move out of the orbit. If you have waited an adequate period of time (3-6 months) to see if the scar is going to improve on its own, then it is probably time to do a scar revision. This should be a simple office procedure with a little local anesthesia and I would expect a good result. Hope this helps, Dr T

Scott Tucker, MD
Winston Salem Plastic Surgeon
5.0 out of 5 stars 32 reviews

Fillers will not help blepharoplasty scars

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Fillers and lasers will not help blepharoplasty scars.

The best solution is a scar revision. This can be very effective. See the doctor who did your blepharoplasty. He/she should be able to help.

Scar revision after lower blepharoplasty

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 A filler will not help. Scar revision may be helpful, but might actually make things worse. I woud discuss this with your surgeon, and probably see another one or two for a second opinion. 

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon

No, something better however.

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Let me be blunt. You are chasing your tail here and wasting money. You have by your standards, an unfavorable scar. This happens on occasion. I would recommend that you go back to the surgeon and tell him your concerns. Then discuss scar revision. This should be a quick and easy office procedure.


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