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

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?

Doctor Answers 6

No reason to freakout

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.

Cambridge Facial Plastic Surgeon
4.4 out of 5 stars 20 reviews

Incision Placement

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)

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Upper Eyelid Surgery - Incision Not in Crease?

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

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Way too early to worry.

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]


A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Upper Blepharoplasty

 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.

William M. Ramsdell, MD
Austin Dermatologic Surgeon
4.7 out of 5 stars 3 reviews


It is still very soon for you determine the final look of your scar. It takes time for your skin to relax and for The swelling to subside. Give your body some time to heal. After a few months that's when you can see the final results and if need be talk to your surgeon.

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon
3.3 out of 5 stars 9 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.