Hi. My 2 yr.old had frontalis sling surgery for his ptosis last year. He got revision surgery 6 weeks ago to lift his lid and repair his double eye crease. The lid lift is pretty good but his eye crease seems worse. His scar is puffy and crooked. Will it heal nicely? What can be done to make it better? Would Mederma work or another surgery..etc? Thank you for any advice/opinions you have.
Will my Son's Scar on His Eye Crease Go Away? (photo)
Doctor Answers 6
Scar after frontalis sling surgery
thank you for your question. Mederma (and other scar creams) is never a bad idea. I recommend that you massage it into the scar twice daily for at least 5 minutes (perhaps while he is asleep?) and continue for six months or so. One can always consider scar revision in a few years, but I'd wait until shortly before he starts school. Please remember that the alternative to the ptosis repair was probably permanent loss of sight in that eye (amblyopia).
Eyelid scar healing.
After multiple surgeries, it is understandable that you are anxious to have your child's healing go as smoothly as possible. At six weeks, it would be very normal to see some mild red color and swelling still in the incision. During the first one to three months, the body is laying down new collagen and other cells to heal. You should expect the redness and puffiness to dissipate between three and six months after the incision. Scar gels can do a great job at accelerating the healing process, and also remember to utilize sunscreen. We recommend a product with SPF greater than 30 to ensure the incision does not absorb too much sunlight.
This is completely reasonable scar for this early after surgery. Though scar creams can be helpful, around the eyelids it is rarely used because of how well it the scars eventually fade and flatten out.
At this time, less manipulation would be best. Be patient [this is hard for a parent].
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This scars will settle down.
It is difficult to use silicone gel on the eyelid crease. It is also probably completely unnecessary. This will get much better on its own with time. Feeling compelled to do something with just make him fuss and unhappy. This would be worthwhile if it was actually accomplishing something but since this looks great and it is only 6 weeks out from surgery, I would recommend not pestering the area. Remember pulling and manipulating this area can cause the suspension sutures to tear which will mess with the effectiveness of the surgery.
For this early after surgery, the scars look as they should. It is normal for good parents to have the concerns you are expressing. share them with your doctor. These should heal very well. It can take at least six months. I would use the topical gels, as they are easy to use, not painful, and you will feel better doing something that can help.
Two Year Old With Scar 6 Weeks Post Surgery
In the course of healing and scar formation six weeks in a two year old child is still very early. Children can have a more vigorous healing response than adults and this could make the healing scar look more prominent. Frequently it takes a healing wound at least six months for the scar to go through the healing process. Some of the issues with scars are width, thickness and altered pigmentation.
In young children we do not favor topical gels or medications on the face, when they can be avoided, as the child may inadvertently place some of it in their mouth, or eyes, etc
In the first few weeks after a procedure, we often recommend application of tape strips across the wound to stop it from spreading. This is to try to control the width of the scar.
If a scar has any signs of thickening we use gentle massage for a few minutes twice a day to try to soften the wound
In terms of skin pigmentation it is important to give your child's body the best opportunity to restore uniform skin pigmentation. Therefore, it is important to avoid sun exposure. Considering the location of this car this can probably be achieved by keeping a hat with a brim over the healing area. The protruding brim will also have the benefit of helping to avoid accidental injury to the healing scar.
Finally, you should check with your child's surgeon before undertaking any advice of this type as the surgeon may have a reason why this advice should not be followed for your child.