These are my eyes two years after upper blepharoplasty. Can I do anything to improve the redness? (Photo)

Question

I cannot leave the house without total makeup on upper eyelid the scars are also visible but I am more concerned with the redness This was a second urgent the first was done 20 years ago This time only skin was excised but years ago obviously the surgeon removed too much fat. Can I do anything? Laser ? Help!!

Kenneth D. Steinsapir, MD · Answer

This is normal circulation in the tarsus, the hard platform of the upper eyelid.  Do not have someone laser the blood vessels of the eyelid platform closed.  That may be possible without damaging the underlying cornea or not.  However that is not the problem here. The problem is that you have POST UPPER BLEPHAROPLASTY SYNDROME (PUBS). The levator tendon which is suppose to extend down the eyelid and insert over the tarsus, is fully disinserted.  It is scrolled up in the scar tissue created when your original surgeon did the blepharoplasty. To remove fat, the septum, a connective tissue plane from the brow bone that inserts just above the normal eyelid crease, was incised to remove fat. When this heals, in predisposed individuals, it pulls the central anterior levator tendon out of position. This white glistening plane of tissue helps hide the red blood vessels that are present deeper in the eyelid. That is why these eyelids are thinner than before surgery and why they are so red. Surgery to reposition the levator aponeurosis in the upper eyelid is needed to improve this situation.

Gregory Baum, MD · Answer

Thanks for your question and photo. It is difficult to say much about the scar widening from the photo provided but I definitely see the erythema (redness ). I'm not sure why you have that redness this far out from your original surgery. I don't think laser treatment will be possible because there's no way to protect your eyeballs from the damage of the laser. Makeup may be your only choice.  I don't think it makes any difference if you use absorbable or dissolving sutures to close the eyelid incisions. I think the scars are the same. Some people just heal great and others not so much. You might benefit from an inperson consult with a board-certified plastic surgeon to see things up close. Best wishes !!

Samuel Baharestani, MD, FACS · Answer

Thank you for sharing your case and photos.  I agree that your incisions are probably wider and more visible than most after upper blepharoplasty.  I like to avoid this by using removal sutures rather than the dissolving type.  I know it's annoying to have stitches removed after surgery, but it helps to avoid complications down the road like yours'.  As for the redness, it is important to see a board certified oculoplastic surgeon to make sure that you don't have blepharitis (eyelid inflammation) that can be treated with over the counter or prescription medications.  In addition, you should try to avoid sun exposure to the area by wearing sunglasses outdoors.  Hope this helps.  Good luck!

These are my eyes two years after upper blepharoplasty. Can I do anything to improve the redness? (Photo)

Answers (3)

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