I have thick ropiness underneath the skin after blepharoplasty, what can I do? (Photos)

Question

I had upper and lower blepharoplasty 18 days ago. Underneath the upper eyelid scars is a very thick rope. It is not above the skin. It is causing a visual ridge. It is continuing to get thicker despite massaging. In one large area it is easily a quarter of an inch thick. It is somewhat painful when touched. What is the best treatment for this ropiness?

David S. Felder, MD · Answer

It appears as though you are healing normally at this point in time. It is not unusual to have a bit of thickening of the incisions a few weeks after blepharoplasty. This should begin to regress in a few weeks and should be fine in a few months.

Philip S. Schoenfeld, MD, FACS · Answer

Fro the photos that you have provided it appears that you are healing well.  The thickening that you are palpating underneath the upper eyelid scar is likely the orbicularis muscle.  It is extremely rare to get any kind of hypertrophic scarring from an upper eyelid blepharoplasty and the fullness you are experiencing should soften and dissipate over time.

Joelle Rogal, MD · Answer

It appears from your photos that you are healing well.  Your symptoms appear to be typical of someone only 18 days postop from a blepharoplasty.  It is important to be patient during this time, as healing can take some time.  That being said, it is important to follow up with your surgeon regularly and discuss your concerns.

Janet Woodyard, MD · Answer

It is not unusual for scars to thicken over the 1st several weeks after surgery. You should speak with your surgeon. I doubt that he or she would want you massaging this early in your post operative course. You could cause further problems. Scars will get thinner and lighten as the scar maturation process takes place. Speak with your physician.

John J. Martin, Jr., MD · Answer

From these pictures you seem to be healing well.  It is not uncommon to have some firmness to the scar at first, especially if there are any buried sutures.  If it remains firm, your surgeon can inject the scar with some mild steroid which will soften and usually eliminate the scar.  Some silicone cream can also help.

Rohit Seth, MD, MRCS(Ed), PhD · Answer

Thanks for your question. You are still very early in the healing process and need to let the body heal. The ridges will normally settle. I advise to not do any vigorous massaging until at least 4 weeks. Any sooner and you are risking widening the scar as the wound is not at its maximum strength during this time. You can moisturise the skin gently but dont massage the scar yet. Let your body heal. You will need to wait at least 3 months to see your final result and so there is still a lot of healing to take place. You will need to be patient and at 3 weeks, I would expect your eyes to still be swollen. The ridges may well be partly to do with the degree of current swelling and as your inflammation settles this will also. Have you used any topical anti-inflammatory agents on this area - witch-hazel works very well. I hope this is of help BW

David Cheung, MBChB, Bsc(Hons), FRCOphth · Answer

Hi greetings from the UK. I must say that your eyelids look pretty good from your pictures. It's pretty normal to get some healing reaction. I would point out your concerns to your surgeon as he/she may suggest that you start some anti scarring silicone gels and less commonly anti scarring treatments/ creams. Best WishesDavid

Elba Pacheco, MD · Answer

Hi and thank you for your question. Wound healing is a process that’ll take months if not a year to complete. The initial wound heals just well enough for the sutures to be removed, but new collagen formation and mild inflammation are the rule at this juncture. At four to six weeks, the ropiness may get worse and the wound contract some, which will feel tight. Ultimately, the process will turn to wound maturation, with eventual softening and return to your natural skin tone. 
Silicone wound healing ointment with or without sunblock is a good option to hasten the process. Pure Vitamin E is also good. Hope this helps, Dr Elba Pacheco

I have thick ropiness underneath the skin after blepharoplasty, what can I do? (Photos)

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