Help - lower bleph scar is thick & indented & changed shape of eyelid 2 years post-op (Photos)

Question

Hi I had lower bleph done almost two years ago. I did it because I had been insure of the puffiness under my eyes for years. Mixed with migrated filler they were really puffy at times. However I loved the shape of my eyes. They are not very empty loose skin and the same is different. But my right eye the scar is thick and indented and it’s changed the shape of my eyelid and eye. It’s actually getting worse with time. I’m going to go back to the surgeon but he has the worst bedside manner.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis.  We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about your experience with your lower blepharoplasty. It's understandable to feel distressed about changes in your appearance, particularly when they seem to worsen over time. Here are some steps you can take to address the issue:

### 1. **Consult with Your Original Surgeon**
Even though you mentioned that your surgeon has poor bedside manner, it's important to discuss your concerns with them first. They performed the initial surgery and might provide insights or solutions.

#### Points to Discuss:
- Describe the changes in detail, including the thickening and indentation of the scar.
- Mention how the shape of your eyelid and eye has changed.
- Ask about potential treatments or revisions that could improve the appearance.
- Inquire about non-surgical options, such as steroid injections, laser treatments, or silicone sheets to soften the scar.

### 2. **Seek a Second Opinion**
If you're not comfortable with your original surgeon's recommendations or need further reassurance, consider getting a second opinion from another board-certified plastic surgeon or oculoplastic surgeon.

#### When Consulting Another Specialist:
- Bring your medical records and photos from before and after the surgery.
- Explain your concerns and the history of the changes.
- Ask about their experience with similar cases and the outcomes of their treatments.

### 3. **Explore Non-Surgical Options**
While waiting for surgical options or if surgery isn't immediately feasible, you might explore non-surgical treatments to improve the scar and eyelid appearance.

#### Potential Non-Surgical Treatments:
- **Scar Management:** Silicone gel sheets or topical silicone treatments can sometimes help to soften and flatten scars.
- **Laser Therapy:** Lasers like the fractional CO2 or erbium laser can help to improve scar texture and appearance.
- **Microneedling:** This can stimulate collagen production and improve the appearance of indented scars.
- **Intralesional Steroid Injections:** These can reduce the thickness of hypertrophic scars.

### 4. **Consider Emotional and Psychological Support**
Dealing with dissatisfaction from a cosmetic procedure can be emotionally taxing. It might be helpful to talk to a counselor or therapist who specializes in body image issues.

### 5. **Document Everything**
Keep detailed records of your symptoms, changes over time, and all communications with healthcare providers. This documentation can be useful for both medical consultations and, if necessary, legal considerations.

### 6. **Prepare for Your Appointments**
When meeting with any surgeon, prepare a list of questions and concerns. You might ask about:
- The expected outcomes and risks of any proposed treatments.
- The surgeon's experience with similar cases.
- Recovery time and aftercare for any new procedures.

### 7. **Review Potential Surgical Revisions**
If surgical revision is recommended, ensure you understand the specifics:
- **Eyelid Revision Surgery:** This could address the scar and reshape the eyelid.
- **Fat Grafting or Fillers:** To address volume loss and contouring issues.
- **Scar Revision Surgery:** To directly address the thickened and indented scar.

### Conclusion
Taking these steps can help you address the issues with your lower blepharoplasty and find a solution that improves both the appearance and function of your eyelid. It's important to advocate for yourself and seek the care and attention you need to feel comfortable and confident in your appearance.

Help - lower bleph scar is thick & indented & changed shape of eyelid 2 years post-op (Photos)

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Everything you need to know about Scar Removal

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Help - lower bleph scar is thick & indented & changed shape of eyelid 2 years post-op (Photos)

Answers (2)

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Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.