3 mo PO upper/lower blepharoplasty, fat transfer, short scar facelift by a BCPS. Cause of ridge line under eye? (photo)

Hello.  Thank you for your question.  The ridge that you see on your right lower eyelid is your scar from the lower blepharoplasty incision.  You are still fairly early in the healing process.  When an incision is closed, it is typical to evert the skin edges so that the scar is slightly raised above the surface of the skin.  This is done so that as the scar contracts and matures during healing, it will result in a flat scar, rather than a depressed scar.  It is also common to get little bumps along blepharoplasty incisions.  These will likely resolve over time as the scar heals and matures.  It typically takes a scar  9 - 12 months to fully mature.  I would suggest patience with the healing process at this time, and it will likely require no additional treatment.  However, if the scar does not flatten and smooth over time, laser resurfacing or scar revision may be indicated.  I would recommend waiting until at least 9 - 12 months after surgery to consider any intervention, unless the scar is worsening with time, in which case earlier intervention may be indicated.  I wish you the best in your recovery process.

Dear Runner 0917,
Thank you for your question. It is difficult to make an assessment and recommendations based on photographs alone. I recommend you continue to follow closely with your surgeon with serial repeat evaluations if your eyelid issues do not resolve with time. The ridge you are experiencing can be due to a variety of issues, including raised blepharoplasty scar or milia. If this issue does not improve with time, follow-up with your surgeon to see if there are additional treatment options to remedy the issue, including possible scar creams or scar revision. 

There are two different approaches to lower lid surgery: one makes an incision inside the lid with no scarring. The other is an incision under this lid, done often when excess skin needs to be removed. The lower lid incisions can be troublesome, as they produce a visible scar and can occasionally pull down on the lower lid.From the photos you sent, it looks like you are experiencing hypertrophic scarring with some pulling down of the lid. I would treat this with steroid injections and massage now rather than waiting another 3 months, as it may worsen. Return to discuss your options with your surgeon.

From the picture at one week, it looks like you were having a reaction to the suture.  This can create a longer healing time, and some additional swelling.  I would recommend using warm compresses and some massage over the area to try and flatten it out.  Some silicone cream may also help.  If it doesn't go down in the next few weeks, some low dose steroid injection may help.   

 most patients are fully healed at three months after a upper and lower blepharoplasty procedure. From the photographs, it appears that the incision is still in the healing process with swelling and edema present. Consider a steroid shot if the scar itself is hypertrophic. Best to follow up with your operative surgeon.