Upper blepharoplasty. Left incision not the crease. Why did he put the incision higher w/ the more sagging lid? (photo)

Question

Hi. I have a upper bleph + canthopexy & fat transfer to upper eyelids 2 weeks ago. My PS is experienced but my right eye incision is not in the crease. I developed little bumps (milia?) and have tract marks on this side only with this scar 3,5 millimeters above the natural fold. I like the right eye, incision is hidden in the fold nicely. Is there a chance my incision drops after in the fold? He starts to cut high and far at the inner corner, it creates like a wrinkle or a double crease.

Kenneth D. Steinsapir, MD · Answer

That is not an excuse because with awareness, the surgeon should be able to compensate for their handedness.  However, it is very common to see a right handed eyelid surgery have a little trouble making a symmetric incision on the left side and vice versa.  The good news is that often this small difference does not matter because the two creases look they tuck under the fold and are mostly not visible.  This is extremely early from eyelid surgery.  Please let yourself heal and consider reposting here at 6 to 8 weeks after healing more assuming that you still having a concern.

Soheila Rostami, MD, FAAO, FAACS · Answer

I would not be too worried. Usually the scars from the upper eyelid bleph. will be so inconspicuous that you hardly can see it. The only thing is that you have to wait for 3 to 6 months. I can tell that you will be happy with the results.

Dan Landmann, MD · Answer

Yes, I agree with you that the incision looks a little higher on the left side than on the right side. But it is still very early after surgery. Usually, the upper eyelid incisions heal exceptionally well, and you probably won't notice anything. Also, if you had fat injected into the upper eyelids, that will cause swelling, which is temporary, so be patient about the little extra wrinkles. The little tract marks are common. They always go away, but your doctor can inject them if they are really bother you. Time and patience will be your biggest asset. Talk to your doctor and ask him how much time is necessary to make a final outcome decision. I typically say that the first real mile stone is at 6 weeks, but it takes a full year for things to completely heal. Good luck!

Flora Levin, MD, FACS · Answer

you are still very early in the post-operative period- too early to make any conclusions. As the swelling continues to go down it will be a more reliable assessment. The bumps will improve on their own or can be addressed. Be patient and follow-up with your doctor to discuss your concerns.

Robert L. Kraft, MD, FACS · Answer

Until the swelling in the right upper eyelid has receded, I do not think you can come to any conclusion as to where the incision was placed. The swelling could skew perception of where the scar will ultimately be.  Milia are quite common after surgery and can easily be addressed.  Discuss your concerns with your plastic surgeon. Best wishes. Dr. Kraft

Steven Wallach, MD · Answer

It is too early to see the final results. You are still swollen. Best to follow closely with your surgeon. Good luck.

Upper blepharoplasty. Left incision not the crease. Why did he put the incision higher w/ the more sagging lid? (photo)

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