I had upper and lower eye lid surgery 9 weeks ago and I can see a scar forming in both upper eye lid area close to the tear duct going towards lower eye lids. My surgeon told me this does not happen usually. He injected me with diluted cortisone three times already but I see no difference. Please help me I am very scared. I am not happy with the results. Is this normal. Thank you
Scarring After my Eye Lid Surgery? (photo)
Doctor Answers 10
Why eyelid scarring can occur during the healing process, and how it can be avoided using precise incisions
This type of fold or web can happen in different case scenarios. The most common scenario is when the skin in the inner aspect below the medial part of the incision is relatively loose. This means that a certain amount of skin was removed and because of the dynamics of tension, a fold can occur. This type of folding is most common in the skin between the eyelid and the nasal area. Another scenario is when the incision line plays a role in the way the skin heals - it can heal a little or aggressively until it thickens.
Web development is generally managed conservatively through massage or the use of steroid and anti-scarring injections. This requires some time to work and great observation of the scar is done. When I see patients who have this, I would wait until the active healing has already occurred. Active wound healing occurs when the initial healing process or collagen remodeling begins to tighten the area until the collagen softens after several months after the surgery. I would also wait around 6 months before pursuing a different procedure to flatten the web or scar.
Another procedure that can help with the webbing and scarring is called a z-plasty. This procedure takes advantage of certain geometric rules. If the skin has relative shortage, then the skin can be moved in such a way to give an absolute amount of skin to compensate for the tension and shortage. At this point, I think the use of steroids is adequate for your case. I would also would suggest doing massage of the area, but first communicate with your doctor if this will be beneficial to your case. I hope that was helpful, I wish you the best of luck, and thank you for your question.
While I understand it is easy to get concerned, your situation may very well improve on its own as 9 weeks is still early in the healing process and the acute inflammation that occurs will very likely improve. If your lids are unsatisfactory at 6 months, that would be the time to seek a second opinion.
It takes longer than nine weeks for scar to remodel after blepharoplasty.
I think your scar will improve without steroids and without massage. I would be more concerned about the lower lid position.
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