Scarring After Upper Eye Lid Surgery

I had upper and lower eye lid surgery 3 weeks ago and I can see a scar forming in both upper eye lids, area close to the tear duct,and a bit along the corners of both lower eye lids. I tend to form keloids but my surgeon assured me he had never ever seen a keloid in the upper lids and I researched it on the web and most physicians agreed with him. My surgeon says I should wait scar still swollen, etc. Please advise, I am very, very worried. thank you in advance.

Doctor Answers 19

Upper eyelid surgery and post operative scars

At just three weeks after your upper eyelid surgery it is still very early in the healing process.  Scars are most noticeable 3 to 6 weeks following the surgery and usually will improve and fade substantially over the next 3 to 6 months, even without treatment.  Check with your surgeon first, but it probably would be safe to begin applying 1% hydrocortizone cream to the scars and/or using a finer thickness of silicon scar sheeting.  If these conservative treatments don't improve your situation, your surgeon may want to consider a small amount of an  injectable steroid such as kenalog or solumedrol.  Please try not to worry, I believe your scars will improve substantially, just give it time.

San Jose Plastic Surgeon
4.8 out of 5 stars 56 reviews

Keloids are very rare with eyelid surgery

IMHO, keloid and even hypertrophic scars are quite uncommon in eyelid surgery in my 20 plus year experience performing that surgery. Follow your surgeons advice and try not to panic.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Give the scars some more time.

A bit more red and inflammed than normal. Be sure you are not putting antibiotic ointment on that is causing an allergy--much more common that recognized. I would recommend you switch to a different ointment--or none. You can use silicone gels--sheeting is simply too difficult in this area. With time I am sure the scars will settle down and look good--the only time I ever have to revise upper lid scars is when the patient accidently opened the scar (typically by sleeping on side and rubbing/pressure against incision) right after the sutures were removed.

The revision is not a big deal and can be done in the office with just a bit of lidocaine...if it comes to that.

Good luck!

Reginald Rice, MD
Folsom Facial Plastic Surgeon
4.3 out of 5 stars 8 reviews

Scar Thickening May Subside

In the early weeks after blepharoplasty, it is common to see some thickening of the scar at the inner and/or outer corners of the eyelid. As the scars mature during the year after surgery, this does usually subside to leave a very satisfactory scar.

Stay closely in touch with your surgeon about your concerns and resist the temptation to have someone meddle with the maturing scar: "quick fixes" can cause more harm than good.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.6 out of 5 stars 39 reviews

Scars after surgery

At this point, it really is too early to tell how your scars will appear once totally healed, which can take about a year or so. Yes, your scars are quite red and visible, but it’s still early and they will become less apparent as the weeks pass. 

Leila Kasrai, MD, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 66 reviews

You will be fine

Trust your surgeon and follow his recommendations. Your scar will be fine. No treatment at this time.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Poor Scarring After Upper Eye Lid Surgery

It is exceedingly rare for upper lid Blepharoplasty scars to "turn bad". While your 3 week old scars are not Keloid like (overflowing the margins of the original incision) they are raised and hypertrophic. Such scars may benefit from being injected with dilute corticosteroids such as Kenalog. The Kenalog may flatten the scars but may also widen them.

Dr. Peter A Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Scars at three weeks, way too early to evaluate

scarring after eyelid surgery is generally very acceptable to imperceptible, if you give it enough time to mature. redness is normal for weeks to even a few months. try some gentle massage. it WILL get better. if there is a scar in the inner corner, it can be treated. this all assumes the incision was properly placed. the incision  looks good on picture but hard to see the inner corner well. good luck.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

These are some ugly looking scars.

Dear Bluemoon

Even though these are ugly right now, it is so very early from your eyelid surgery.  In time these incision will quiet and be much more acceptable.  In the photos, you show absolutely on evidence of keloid formation.  The scar is a little ropey in the upper eyelids toward the nose.  An option at this point would be to inject relatively dilute kenalog into the thickest portion of these to help speed their resolution.  However, it is very likely that these will quiet even without the steroids.  How long will this process take?  My crystal ball says that these incision will be much, much better in 4 months and even better improved at 6 months.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Eyelid Scarring

It's not unusual for patients to have noticeable scarring in the immediate post-operative period following blepharoplasty surgery. It's important to realize that all incisions heal with some scarring, but the eyelid skin has unique qualities that tend to minimize scarring.

In the immediate post-operative period, eyelid incisions tend to be red and raised. These scars tend to respond nicely to massage and avoidance of sun exposure. Although keloids are unusual following eyelid surgery, hypertrophic scarring does rarely occur. Under these circumstances, gentle massage and rarely steroid injections will alleviate the problem.

It's important for patients to maintain close contact with their plastic surgeon when hypertrophic scaring occurs. Your surgeon should be able to formulate a treatment plan that ultimately addresses this problem.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.