3 years post op - Do I need revision or can I fix the scars? (Photos)

Question

I had eyelid surgery 3 years ago and I have white scars and it’s very noticeable and below the incision scars my eyelids are kinda purple tint , I’m not sure why ? They were not like that before. I was told I’m not a candidate for co2 laser by one surgeon bc of my skin color and ethnicity ( Asian) my surgeon suggested different skin treatments, not of them worked. At this point , is the only option revision? The scar is not a straight curved line like I see most others. I’m very self conscious about them.

Eric M. Joseph, MD · Answer

Since your scars are visible with your eyes open, you may have what is called upper eyelid ptosis. Ptosis is when the upper eyelids are a bit droopy, exposing the upper eyelid excessively. You may be a candidate for ptosis repair, depending on your examination. I would suggest Consulting with a reputable oculoplastic specialist about your specific concern. Wishing you well moving forward! Sincerely, Dr Joseph

Jeffrey M. Darrow, MD · Answer

Your present scar is widened and of a lighter color than your surrounding skin. A very carefully performed revision of the scars would likely give you your best result as it can remove, as much as possible, your present scar, and leave you with a new one which should be closed with a running subcuticular pull out suture to give you the best scar quality possible. I am not sure why your eyelid skin just above your eyelashes is a different color, but you may get some insight in that with a consultation to a dermatologist. Best wishes.

Zoran Potparic, MD · Answer

Usually, upper eyelid scar is one of the finest we see after surgery. However, in some patients it may appear wider, stretched or dyspigmented (uneven pigment distribution). I am not sure that a surgical scar revision would guarantee better result? Treatment of darker areas bellow the scar with peel, hydroquinone, or similar "bleaching" remedy may be considered. Good luck.

Nelson Lee Novick, MD · Answer

For many years, I have been treating hypopigmented scars from all causes, including post-surgical as in this case, with gratifying results employing a combination of in-office, professionally performed manual microneedling (no need for the added expense or risks of RF microneedling) accompanied by the application of Rx topical pigment enhancers, such as tyrosine and latanoprost. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist. Hope this helps and best of luck.

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment regarding the outcome of any plastic surgery procedure, we need a proper set of before and after pictures.
If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took.
It’s common for people to have a transitioning color change along their eyelid.
When a strip of skin is removed during this transition The patient will have an abrupt color change.
Seem to be holding your brow up in your picture.
What we need to see is what you look like without facial expression.
I don’t think there’s anything you can do at this point regarding your outcome that’s going to be meaningful.
Without facial expression, you are, may be better than presented.
People generally don’t see you with your eyes closed.
Best,
Mats Hagstrom MD

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