Upper blepharoplasty has 2 instead of one incision. Any suggestions? (photos)

It is post op day 2 and I noticed 2 scars/ incision/ folds instead of one across my eyelid. Is this normal? Will it heal with 2 or one fold? Please do advise. Thank you.

Doctor Answers 12

Scars vs folds

I am sorry that you are having issues about your procedure and thanks for sharing your question. I can appreciate your concern.

I think you have a line that is your incision, and another one that is a fold of your skin.

It is difficult to determine the reason for your problem since is very early after your surgery.

Finally, make sure that your doctor is aware of your process. He should be able to guide you best in your care.

Wishing you the best in your journey

It's not another incision but an accessory skin crease

Hi Hailey. Greetings from the UK! I've had a good look at your photos. The lower line is the surgical incision. The upper line represents an accessory skin crease which was probably faintly already present before surgery. I myself try to look for these preoperatively and ablate them during the surgery as they can become more apparent following a blepharoplasty as the vectorial forces change and the skin becomes temporariliy thicker. More often than not they disappear as the swelling reduces so I wouldn't advocate worrying about it at the moment. However if they remain persistent and a cosmetic issue they can be ablated with varying success rates with a revisional blepharoplasty. 

David Cheung, MBChB, Bsc(Hons), FRCOphth
Birmingham Oculoplastic Surgeon
5.0 out of 5 stars 2 reviews

Incisin questions

its hard to tell however you are only 2 days out, the eyelid incisions heal very well so give it time and follow up with your surgeon. Continue with the recommended post op care and give the area time to heal. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Two incisions for upper bleph

It is difficult to tell the reason for the second incision as it is unusual. You should ask your surgeon. However, it should heal well to the point that you will hardly notice it. 


Dr. J

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 107 reviews

2nd crease

It looks like a second fold above the one created by your doctor. It can be made worse by the swelling caused by post op edema. You should allow for adequate time for healing before making any conclusions about your results. Should this persist after adequate healing, it can be corrected.

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 22 reviews

Upper Blepharoplasty

Thank you for your question and the supplemental photos.  It is difficult to tell from the photos exactly what has caused that second incision but it appears to most likely be a scratch.  With that said, I would highly recommend following up with your operating surgeon to discuss your concerns.  You are still very early in the immediate post-operative period, but I think it is always important for patients to address any procedural questions or concerns directly with their operating surgeon who is most familiar with your specific case.  I wish you the best and a speedy recovery!

Stephen T. Greenberg, MD
Woodbury Plastic Surgeon
3.9 out of 5 stars 58 reviews

Stuff happens. This is why you sign a very long and complicated consent before surgery.

Obviously, there should not be a second incision.  Did your surgeon have an explanation?  It is not the reason that you have two folds.  You have two fold because the surgeon did not control the upper eyelid crease.  The reality is that very few surgeons know how to control the upper eyelid crease.  This is an area that is normally hidden when the eyes are open.  Now you need to carefully follow your surgeons directions and let the eyelids heal.  As you heal, these issues will either resolve or persist.  Many things that look like an issue initially to in fact get better.  So try not to freak out about these issue.  If the problems are still persisting after about 2 months, consider reposting on RealSelf for more input.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Second incision of upper blepharoplasty

The pictures are limited but it looks like the second line is likely a scratch but its early to tell. It will likely heal without any noticeable scar in 10-12 weeks. Follow closely your surgeon's instructions.

Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon
4.4 out of 5 stars 20 reviews

Upper Blepharoplasty

Thank you for sharing your case and photos.  In a few days the incision will start to fade in your eyelid crease and become nearly invisible.  Make sure that your surgeon is aware of your condition.  Good luck!

Samuel Baharestani, MD
Long Island Oculoplastic Surgeon
4.8 out of 5 stars 31 reviews

Second scar?

This early on it is hard to tell.  What you are seeing may just be a scratch or just a bit of clot on top of the skin. Make note your PS just in case.

Best wishes

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 104 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.