Lower Eyelid Surgery One Year Ago and I Have These Suture Marks (train Tracks) Scars Under my Eye? (photo)

Your scars underneath your eyelid appear significant.

You may want to consult a surgeon with considerable midface (cheek lift) experience who uses lasers on a daily basis for your options.

Your next step will be very critical.  Only select the very best at this point if you decide to have revisional work on your eyelids.

The picture posted shows scleral show and cicatricial ectropion in addition to the very elongated suture tracks.  The photo appears to show a situation in which excessive skin was removed and therefore a higher than acceptable degree of tension was placed on the wound; these conditions are often associated with dry eyes and corneal irritation. Unacceptable lower eyelid scars are unusual in most experienced Surgeons hands.   I agree with Dr. Vilar that this condition has a high likelihood of becoming worse if not treated by a Surgeon well versed in treating challenging lower eyelid issues.  I recommend seeing an experienced Occuloplastic or Facial Plastic Surgeon for further evaluation.

Frankenstein or tract marks typically occur when sutures are too tight, left in too long, or get infected.  Some people just heal that way from genetics.  Your pre-op photos would be helpful, but it appears you have ectropion.  This typically occurs if too much skin is removed and/or if you develop a post operative hematoma.  This is a serious problem that could worsen in the wrong hands.  Seek a very very experienced plastic reconstructive surgeon, or very very experienced oculoplastic surgeon.  Keep your eye well lubricated until you get this fixed.  Your cornea is at risk.

Those suture marks are the result of having lower eyelid blepharoplasty done from the outside where an incision was made and skin was overlapped with stitches. When it healed, you developed these marks.

When someone has adequate skin, my approach in removing the stitch scars would be to excise the skin that has the marks or at least much of it as possible. Sometimes, we can improve this area with laser but because the skin is so thin, it’s a very tricky thing to consider given that you also have retraction and ectropion.

You’re dealing with an issue where there are multiple problems in terms of tissue availability. That means if your eyelid is rotated out, there can be a skin shortage so you need more skin. If it is retracted, then the middle layer of the skin needs some vertical height. So you might need more than just dealing with these suture marks, but this dependent on your perception of your cosmetic outcome as well as how aggressively you want to deal with the functional aspect. In ophthalmology, having eyelids that function well is critical for eye health. So it’s surprising to me that you are not concerned about symptoms related to tearing or dry eye.

Your concern about the mark is of course important but I think in the big picture, the position of your eyelid in relation to the health of your eye is a more significant and needs to be addressed. My suggestion is to consider a strategy to help address the eyelid retraction and ectropion. I would recommend visiting an oculofacial plastic surgeon with a lot of experience in this area particularly in the cosmetic area. I hope that was helpful, and thank you for your question.

Thank you for your question and photo. Unfortunately you have significant scarring on the skin surface and within the eyelid tissues. This is causing lid retraction and ectropion.  Lasers and chemical peels will not help and may be harmful.  I would recommend consultaiton with a Plastic Surgeon experienced in lower eyelid reconstructive procedures. You will need a canthoplasty with or wihtout a  cheek lift and lid spacer graft.  You may also benefit from skin grafting or flaps to improve the appearance of the skin. Best wishes on your recovery.