Intervention Needed For Upper Bleph Scarring? (Photo)

Question

It's been over 9 months since I had my Upper Bleph surgery. I thought the scarring would be hidden in my eyelid crease however my scars extend out past the eyelid and I have substantial scarring on my right eye past the eyelid. It is quite noticeable and makes my eye appear to slant downward. I have not seen improvement in at least 3 months. I'm unsure how to address this with my surgeon. Is scar revision usually an extra cost by a surgeon who has preformed the surgery?

Michael A. Persky, MD · Answer

Hello Vanessa,
Occaisionally the lateral component of upper bleph scar can widen and be visable. When this occurs, I perform a scar revision under local anesthesia in the office at no charge to my patient.  Your surgeon should do this for you as he/she/they want you to be happy and an excellent representative of their work in your community.  Let your surgeon know that you are unhappy with your scar.  Good luck and be well.
Dr. Persky

Metin Temel, MD · Answer

The problem will be solved with scar revision or fractional carbon dioxide laser, but it is difficult to say anything about the costs.

Mats Hagstrom, MD (license on probation) · Answer

The length of this car is often determined by how much skin is removed.
Making the scar too short will cause the contour irregularity called a “dog ear”. 
The length of your upper eyelid blepharoplasty seems appropriate, but in order for us to understand your outcome, we always need to see a complete set of proper before and after pictures.
 If you don’t have before, and after pictures then ask your surgeon to forward the pictures they took.
There are generally three variables that will make the scar visible from this procedure.
One is the color of the scar itself, which does not seem to be an issue.
There is also often a slight change in skin pigment, which is removed with the strip of skin making the transition in skin pigment much more abrupt after an upper eyelid blepharoplasty.
This is an unavoidable with the removal of skin in a transitioning area.
The third issue is three-dimensional contour irregularity.
Three-dimensional contour irregularity is the only part of the scar that could potentially be improved and there is some of this in the very lateral aspect of the scar. The most lateral aspect of this scar might improve from scar revision surgery.
Revision policy should always be discussed during in person consultations before having surgery.
By contractual agreement, surgeons are not obligated to perform revision surgery unless previously agreed. 
Many will when they feel it’s appropriate.
I suggest you continue following up with your provider or schedule a few in person second opinion consultations with other plastic surgeons in your community if needed.
For second opinion, consultations always come prepared bringing with you a complete set of proper before and after pictures and a copy of your operative report.
 These should be obtainable from your current providers office if you request them.
Best,
Mats Hagstrom MD.

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