What Can Be Done to Improve Suture Scars on Eyelids?

What can be done to improve suture scars on eyelids as well as pixied look at the corners of the eyes? I had an upper bleph done 6 months ago and still have little uneven bumps on my upper lids, as well as a pixied look at the outer corners of my eyes. It looks as if I have 2 flaps of skin hanging over each side that are pinched at the ends.

Doctor Answers 7

At 6 months after blepharoplasty, digital massage can be helpful

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At 6 months after blepharoplasty, digital massage can be helpful, particularly in the corners where there may be some skin tightening and scarring.  If there are true suture cysts, meaning little bumps at the sutures, those can be lasered.  But generally, I tell patients to massage twice a day with either a mild steroid ointment that can be used around the eyes or coco butter.  The massage will often relax the incision as well as get rid of the bumpiness.  If there is a lot of sutra related bumpiness due to contracted skin, injection of a steroid or a steroid combined with 5FU is my treatment of choice.  It’s only if these do not work that I recommend further surgery.

Lasers can improve eyelid scars

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Eyelid scars that are still prominent six months after eyelid surgery are unusual. It is likely a conservative laser resurfacing would help.

Revision of bleph scars...

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It is not uncommon that the scar line from having your blephs done to temporarily have little bumps on it.  This is because of a small reaction to the suture material.  Your doctor could inject a steroid to smooth it out at one of your post operative appointments.  If that does not improve the bumps, then a small revision may be necessary.  As for the corner, it sounds like a small revision may be needed, or if the excess skin is lateral to the eye, a browlift may be needed.  You should certainly review your concerns with your surgeon, and/or seek another opinion from a board certified surgeon.

Eyelid Surgery Scars

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Fortunately, neither of the problems is a big issue. 

The bumps in the suture line most likely represent suture cysts, like little balloons, which can be readily "popped."  This is done while you're awake in the office, and shouldn't leave you with any downtime afterwards.

As for the flaps of skin at the end fo the incisions, these too can be easily treated in the office.  Using local anesthesia, the excess skin can be excised, and the incisions closed with sutures. 

I'd return to your surgeon;  I'm sure he/she will be able to take care of the problems.

Improve scars after Blepharoplasty

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It sounds like you have excess skin on the outsides of your eyelids that may need to be removed by opening up the outer section of your previous Blepharoplasty scar.  For the uneven areas, scalpel abrasion should help even the skin out.

Unsatisfactory blepharoplasty scars

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Dear Nicole,

Most post op scar changes usually settle down by 6 months post op.  The irregularities that you describe can be addressed in an office setting with local anesthesia.  Best to visit with your original surgeon to allow him some follow-up on his surgical results.  I have never done anything that is perfect.   Ask my wife.

Good luck to you. 

Craig Harrison, MD, PA
Tyler Plastic Surgeon

You are at a point were it is possible to revise these scars.

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Your original eyelid surgeon should be able to revise the scars.  If there has been a breakdown in the relationship, you will need to consult other eyelid surgeons for this work.  There is no substitute for a personal consultation.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a website with a geographic directory to help you find a well qualified eyelid surgeon in your area: asoprs.org.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

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