Multiple eyelid folds after upper blepharoplasty - what can I do to get rid of them? (photos)

Question

I had an the intial upper blepharoplasty to address sagging of upper eyelids 12/01/2020 and then a scar revision done 10/2/2021. The little folds/rolls developed after edema decreased from intial surgery and didn't improve with scar revision. They definitely weren't there prior to surgery (see photos). I feel as if they are making my eyes look much older than even before surgery. Why did they develop? And what can I do to get rid of them? Any help is greatly appreciated!

A.J. Amadi, MD · Answer

It is possible that you have mild ptosis, and that you would benefit from ptosis repair in combination with anchor blepharoplasty. The eyelid crease was likely not reinforced during either of your surgeries, and due to swelling and possibly subtle eyelid ptosis, your have developed multiple skin folds. If you plan on revision surgery, an Oculofacial plastic surgeon (Oculoplastics) is your best option. Virtual consultations are available.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Kenneth D. Steinsapir, MD · Answer

THe formal name for those multiple lines is crepey eyelid platform skin. You also have upper eyelid ptosis. The problem here is that excess skin has been trapped on the eyelid platform below the upper eyelid crease. This is fixable but requires a fussy revisional surgery that you will not find where you life. I am attaching a video about detailed eyelid surgery. Your eyes can be your best feature. There is no substitute for a detailed in person assessment.

Multiple eyelid folds after upper blepharoplasty - what can I do to get rid of them? (photos)

Answers (3)

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