Will I develop hypertrophic scars with pinch blepharoplasty like I did with my facelift? (Photo)

I developed painful hypertrophic scars after a face lift 7 months ago. My new PS told me they may be from tension, internal sutures and surgical technique. I am scheduled for upper and lower pinch blepharoplasty of eyes in 3 weeks and am terrified of developing hypertrophic scars around my eyes. I am 53, healthy and do not smoke. I had no previous history of poor scarring. Please give me your opinions regarding this matter and advise ways to decrease a poor outcome. Thanks!

Doctor Answers 12

Keloid following Blepharoplasty

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Fortunately, keloid formation within the central 1/3 of the face is extremely rare.  Tension, wound healing, and genetic factors are all contributing factors to the development of hypertrophic scars and keloids

Lafayette Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Do hypertrophic scars develop after blepharoplasty

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Thank you for expressing your concerns. Fortunately, scarring and keloids are highly unusual after blepharoplasty. The eyelid tissue is highly vascularized, which helps with healing.
Good luck with the surgery.

Hypertrophic scarring after blepharoplasty

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It is extremely rare to get hypertrophic scarring after blepharoplasty especially if there is no excess tension placed on the skin closure.  The area off hypertrophy you have shown in the photograph is usually under a lot of skin tension and that is the primary reason for developing the hypertrophy.  No scars need to be reexcised with extensive undermining to reduce any tension on the skin closure with close follow-up.  At the earliest sign of any hypertrophy Kenalog Injection should be instituted along with possible laser treatments.


Dr. J

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews


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Some hypertrophic scars are more common behind the ears after a facelift. The eyes tend to heal without problems. 

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Blepharoplasty scars compared to facelift scars.

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Unlike a facelift, there is little tension on the scars of a bphepharoplastly.  Consequently, the development of hypertrophic scars is unlikely. Now that you are more than 6 months after the facelift, this would be a good time to discuss either injection of the hypertrophic scars or revision by excision and resuturing. Good luck.

John M. Weeter, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 7 reviews

Ugly Eyelid Scars after a Pinch Blepharoplasty

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Ugly, raised scars are usually the result of the interaction of genetics/ethnic predisposition (such as Asian/American Indian/ Black), undue tension on the edges, area of the body operated on and surgical technique.

Having such scars with a Pinch blepharoplasty where a minute amount of skin is removed under the lashes and the skin is closed under very little to no tension is extremely unlikely.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Hypertrophic scars after facelift -- worry for blepharoplasty?

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Hypertrophic scars after blepharoplasty are exceedingly rare.  If  you haven't sought treatment for the ones you have behind your ears, I would go back to the surgeon who did the operation for injections into the scars.

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 32 reviews

Hypertrophic scars after eyelid surgery

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 Hypertrophic scars after eyelid surgery especially on the lower lids is exceedingly rare. The hypertrophic scars present in the facelift may be from a variety of factors including tension placed on the incision.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Hypertrophic Scars Following Blepharoplasty

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Thank you very much for your question.

Hypertrophic scars in that location are often from tension on the skin following the facelift.  There is very little tension on the incision after a blepharoplasty, and a hypertrophic scar on the eyelid is pretty rare.  Best of luck!

Hypertrophic scars with blepharoplasty

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It is less likely to see excessive scarring with blepharoplasty than with other areas of the body, specifically the facelift scar behind the ears. You should return to your plastic surgeon for treatment of the scars from your facelift. My article on hypertrophic scars and keloids follows.

Hypertrophic scars and Keloids

First, the difference between hypertrophic scars and keloids. Hypertrophic scars are scars which stay excessively red and bumpy for longer periods of time and are more exuberant than average. Keloids however are an overgrowth of scar tissue, mostly collagen, into normal territory which is seen much more commonly in darkly skinned persons. Most hypertrophic scars will eventually settle down although they deserve and need treatment in the interim. Keloids however, are much more difficult to treat and may recur despite many forms of treatment.

There may be a genetic relationship as some patients inherit tendencies to develop excessive scars. The cause of the scar, age of the patient, location on the body, and other factors can be contributory. Certain areas of the body for instance are more common to develop hypertrophic scars and keloids such as the chest and breast area. Usually the face is less inclined to develop excessive scarring although many patients have keloids forming from ear piercings and other body piercings. Infection will increase the likelihood of excessive scar formation. How the scar is caused also has an effect in that sharp scalpel incisions will be less likely to cause a scar than traumatic tearing or contusion type wounds.

There are a number of treatments for scars including topical treatments such as creams and ointments, bandage type treatments such as silicone strips or pressure bandages as well as injections and laser. Sometimes despite almost any treatment the scars continue to be a problem.

Richard O. Gregory, MD
Orlando Plastic Surgeon
4.6 out of 5 stars 13 reviews

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.