Scarring After Upper Eye Lid Surgery

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.

Your surgeon is correct.  Three weeks is very early.  There are no tear ducts in the upper lids (they are in the lower lids and are usually unaffected).  I have not seen a keloid of an upper lid scar either.  Rarely, I may revise one if the scar is not ideal.  Swelling takes a few months to resolve.  So try not to worry and just give it time.

Three weeks after an upper eyelid blepharoplasty, the incisions are still in the earlier phases of maturation.  The redness will fade and the scar is likely to be much less of an issue.  Your Surgeon is correct that keloids do not form in the area around your eyes; the deltoid, chest and earlobe are typical areas where keloids can form.  

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. 

You can be certain that scars from surgery 3 weeks early will improve dramatically without treatment. If they are not satisfactory after 1 year, surgical revision or laser resurfacing can be performed. Keloids are extremely rare in the eyelids. 

Hello! Thank you for the question! Keloids following this procedure is very uncommon. It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.Hope that this helps! Best wishes!

Your surgeon is correct.  We rarely see poor scarring in the upper eyelid area.  This is one of the best healing areas on the body.  The time is too soon to form an opinion on the final outcome.

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.

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!

From what i can see in your pictures, you are way too early to be overly concerned. I have been doing eyelid surgery for 35 tears and have never seen a keloid scar in any race. Folow up with your surgeon