Are Incisions for Upper and Lower Eyelid Surgery Suppose to Extend over a Half Inch out from the Eye? (photo)

This pictures are 5 weeks post op. My eyelids are still red and puffy and the incisions look bad. I did go back to the surgeon and he put botox in the corners of eyes to "aid in healing" and to help it look better. I did not see any improvement. I also have a bulge in the inner corner of my eye.

Doctor Answers 6

Natural Healing and the Different Styles of Cosmetic Eyelid Surgery

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As a specialist in cosmetic eyelid surgery, approximately 20% of my practice involves revisional work where people come to me all over the world to enhance or revise surgery done elsewhere. And I do emphasize in any discussion with a prospective patient for revisional work is to continue their follow-up with their doctor to see if any of the issues can be resolved.


I can see from your photos that many plastic surgery textbooks show that exact curved shape for removal of skin in the upper eyelid, but it’s not something that I necessarily do in my practice. From my aesthetic sense, the design is a little bit different. Basically, any doctor would do it in their own style and their way. My style is different but that doesn’t mean that your surgeon in any way did anything wrong.

When it’s this early in the healing stage, you may have to wait and see where things go. The aesthetic result of eyelid surgery can take several months to up to a year, especially if there are issues related to fluid and swelling. Also, the incision line does have a tendency to fade, especially in people who have light skin.  In your case, I think the incision is normal and it is something that is within the standard of care of any surgeon.


I’m sure your surgeon will be guiding you as to how to manage the incision and what to do to take care of it properly. I advise you to avoid excess sun exposure and wear some type of moisturizer with sunblock to protect the skin. If it’s necessary, your surgeon would be willing to do any kind of enhancement. In the field of plastic and cosmetic surgery, enhancements are always part of the responsibilities that we surgeons take on when there is need for revision.

I recommend that you communicate with your surgeon. If for any reason your surgeon is not being as cooperative or as communicative as you like, then meet with an eye specialist so that you can get a balanced sense of what to anticipate as time goes on.

New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Long Incisions after Upper and Lower Eyelid Surgery

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     Longer incisions in upper and lower eyelid surgery can be utilized to manage crow's feet.  At 5 weeks postop, you still have swelling.  If you are referring to the medial aspect of the upper eyelid, you may have remnant fat pad there.

Extension of blepharoplasty incisions

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First, it's common for the incision to be red and puffy at about 5 to 6 weeks post surgery. It will improve with time. It may take several months for the redness and puffiness to subside completely. The incision beyond the eyes and merging onto one of your "existing crow's feet wrinkle" is used when you have significant amount of redundant skin. Typically the incision is limited within your eyelid skin and I avoid extending the incision beyond the eyelids unless it's absolutely necessary. In any case, you are still well within the typical  recovery period. Try to have regular follow up visits with your surgeon to monitor the progression of your healing.

Best Wishes,

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Extension of Incisions, Upper and Lower Eyelift

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Often surgeons will extend their incisions into a "crows foot" type wrinkle.  It also depends how much extra skin you had.  You are still early in the post operative course.  I would still communicate with your surgeon.  Let him/her know your thoughts.  He should be able to get you through the post operative period.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Honestly, there is no excuse for incisions like these.

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Your doc may have a variety of legitimate sounding reasons for why your incisions look this way.  However, there really is no good reason for these.   The good news is that they will look better with time.  5 weeks is very early from surgery.  This scars will look much better after 6 to 12 months.  Scars can be revised if they are still unsatisfactory after this time frame.

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

It Depends On They Amount of Excess Skin You Had On Your Upper Eyelids

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If you had alot of excess skin on your upper eyelid, the incisions can be taken a couple of mm from the corner of the eye.  If the surgeon did a lower bleph through the skin of your lower lid and was trying to elevate and remove alot of skin in the area, the incisions are sometimes taken a couple of mm away from the corner of the eye. 


I hope this helps!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.