Upper Eyelid Surgery - Incision Not in Crease? (photo)

Question

I had upper bleph surgery 72 hours ago by supposedly one of Seattle's "best" surgeons, and the incision on my right eye is not in the crease. I'm a little freaked out by this. I had few expectations, but that the incision was going to be *in the crease* and so would not be visible when my eye is open was definitely one of them -- and is what he said he was going to do. How bad is this going to be and what are my options for hiding the scar?

A.J. Amadi, MD · Answer

I agree with you that there seems to be a crease visible below the incision site. . There are a couple reasons this may be so.

	First, not every patient has one eyelid crease. Some patients, as they age and the eyelid fat atrophies, the overlying skin will become more redundant and multiple creases may form. Your surgeon may have placed the incision in the more prominent crease. As others have mentioned, this may also have been done to make the incisions more symmetric.

	Secondly, as others have mentioned, due to the postoperative swelling [and at three days, its probably at its worst] the incision site is very visible. As the swelling recedes, the incision will start to involute into the normal fold of the upper eyelid. Further more, eyelid swelling may also be asymmetric.

	Now if all of the above resolves, and at three months, the incision scar is still visible, revision is still possible. A high crease can be lowered [if there is still enough residual skin present to allow eyes to close]

Asif Pirani, MD, FRCS(C) · Answer

I see what you're commenting on; however, a this point all you can do is wait and see what happens.  If at the 6 month mark you can still see a crease below the incision, you should discuss revision with your surgeon.  I wouldn't suggest a revision before this time point, however.  

	Also, you are clearly anxious about this - you should discuss this with your surgeon.  Perhaps we are being fooled by the post-operative swelling, and your surgeon did place the incision in your crease.  It's best to hear it from the horse's mouth, so to say.

	Patience is the key for now.

	Best of luck,

	Asif Pirani, MD, FRCS(C)

Darryl J. Blinski, MD · Answer

See the placement of the incision but at this very very early healing stage I can not recommend anything more than observation.

Edwin Ishoo, MD · Answer

Its only been 3 days since your surgery. It is inappropriate to be "freaked out" at this point. The results do not reflect final results for approximately 3 months and at this point there would be no intervention advised even if the incision is not in the crease. In some individuals, their supra tarsal creases are asymmetric and a surgeon is likely to correct that at the time of the blepharoplasty. I would advise concentrating on your recovery at this time and follow up with your surgeon as you heal.

William M. Ramsdell, MD (retired) · Answer

I agree that your incision was not placed in the crease. It may have been intentional to make your right eyelid match the left. I agree with the other surgeons that it is too early to evaluate your ultimate results. Your lid is quite swollen between the incision and the lashes. As this clears, your eyelid incision and crease may retract backwards and become not noticeable. "Tincture of time" is your best approach for now.

Upper Eyelid Surgery - Incision Not in Crease? (photo)

Answers (6)

Answer: No reason to freakout

Answer: No reason to freakout

Answer: Upper Blepharoplasty

Answer: Upper Blepharoplasty

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Everything you need to know about Eyelid Surgery

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Upper Eyelid Surgery - Incision Not in Crease? (photo)

Answers (6)

Answer: No reason to freakout

Answer: No reason to freakout

Answer: Upper Blepharoplasty

Answer: Upper Blepharoplasty

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.