Will Laser Help with Scarring from an Upper Bleph Two Years Ago?

       Hyperpigmentation and some scar qualities can be improved with laser, but blepharoplasty scars typically heal very well.  Kenneth Hughes, MD Los Angeles, CA

Blepharoplasty scars are usually highly acceptable. If not, scar revision under local should yield the best results.

Unfortunately, once the skin is cut, even with very precise cosmetic surgery, the skin heals with collagen formation creating a permanent scar.  If your upper eyelid scars are visible because of poor placement and your skin is firm enough that the scars can not be shifted into a less visible location, then we must consider making changes in any other characteristics of the scars that make them more noticeable to you.  For instance, if they are paler than surrounding skin, you could consider having permanent makeup tattooed into the scar creating a darker color that blends better into the surrounding skin.  If the scars are too dark, then a laser might help lighten them to match the surrounding skin.  If there are slight bulges (dog ears) at the ends, then perhaps a minor surgical revision could smooth the scars, which would make them less visible.  The important thing is too understand that your scars are permanent, but scar revision techniques might still offer a  possibility of improving some of the characteristics that bother you the most, thereby making the scars less visible and objectionable to you.

The key to an excellent blepharoplasty is marking the patient appropriately before the procedure to ensure that the incision lines lie within the appropriate creases to make them imperceptible.  Unfortunately, if you have incisions from your initial blepharoplasty that are very near to your brows this may be difficult to improve with revision surgery.  IPL would only benefit you if there was hyperpigmentation of the scar making it more noticeable.  Lasers would be unlikely to prove any benefit in your particular situation.  Small standing cutaneous deformities (Dog Ears) may benefit from minor surgical revision to allow them to lay flat.  I would recommend you revisit your concerns with the surgeon who performed your secondary blepharoplasty so that they may help you obtain an optimal result.

Best Regards,

Jacque P. LeBeau, MD

LeBeau Clinic

Unfortunately, scarring is permanent and in your case there is no "easy" fix. I am doubtful that IPL would help. You may see some additional improvement with time. The dog ears could be treated either surgically or with steroid injection.