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Should Blepharoplasty Scars Be Less Evident by Now?

I had eyelid surgery 5 weeks ago and my scars are still prominent even with makeup. I have followed recovery instructions and use an oitment my doctor had me start 5 days after surgery to hasten healing.

My scars are not only a very visible and long redline, they also are thick and raised -- very promenent when I close my eyes and touch my scar. The doctor said this is no problem, such evident scaring is normal at 5 weeks. However, I have read in more than a few articles and websites that eyelide scars should be not much noticeable by this time.

Am I impatient? Or, if red, thick texture lines at 5 weeks is not usual, what should I do? This is my second eyelid surgery. Does that make a difference?

Doctor Answers 18

October 26th, 2008

All incision scars go through a maturation phase

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This is a good question.

Whenever you have a wound or incision, the healing scar must mature, which involves multiple phases of collagen transformation. At six weeks, the collagen is the thickest and then over several weeks flattens. At the same time, the overlying epidermis of the skin turns red or pink and then over several weeks returns to your normal skin color. However, incisions may still be distinguishable depending on factors which you really can't control - genetics, infection, etc. However, blepharoplasty incisions tend to heal very well. The best way to help your incisions is to leave them alone and allow the healing process to occur. Many ointments and lotions cause irritation, especially with continued use. Another important factor for healing incisions is to protect them from the sun with SPF lotion or, as in the case with blepharoplasty, wearing sunglasses.

I hope this was helpful.

David Shafer, MD
NYC

David Shafer, MD, FACS
October 28th, 2008

Thick, red, raised eyelid scars are not normal after 5 weeks

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Of course, you are understandably anxious, and may not be describing things quite accurately, but if your scars are as prominent as they sound, then there is a problem. Hypertrophic scars or keloids are almost unheard of in the eyelids, so I am not sure what to suggest, but definitely talk to your doctor.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

August 10th, 2010

At six weeks, scars are at their worst

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Eyelid and skin incision scars go through a healing process. At six weeks, incision are at their worst in appearance so I wouldnt worry. I would avoid the sun because that tends to prolong the healing. If you have had a cut before you would know that the instant you had a cut, it didn't look that bad. However over a couple days it got red, left a scab and then started healing. These incisions should resolve without a problem within the next several months. This is still in the early stage of the game.

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon

October 26th, 2008

Be patient

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While all patients scar differently, most upper eyelid scars heal very well. In general scars in most places tend to look fairly red and inflammed at about the 6-8 week mark, and continue to mature for up to a year, somtimes longer. I would tell you to wait several months before considering doing anything else. The thickness of the scars should also improve during this time. It should not make much of a difference that this is your second eyelid surgery.

Vishal Kapoor, MD

Vishal Kapoor, MD
Beverly Hills Plastic Surgeon
4.4 out of 5 stars 13 reviews

October 26th, 2008

Don't panic, but there may be ways to speed blepharoplasty recovery

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Don't panic. Upper eyelid incision scars usually heal beautifully with barely perceptible lines. Occasionally, these incisions will take longer to heal, especially if large amounts of skin were removed or the incision was extended farther to the outside to remove more skin.

The skin involved in healing is thicker in these situations and can take longer and remain thicker for a longer period of time. All this being said, what I usually have my patients do is to massage the scars gently 3-4 times per day and try to avoid using makeup or cosmetics that may create further irritation, redness, and swelling.

I also offer my patients pulsed-dye laser treatments combined with some injections to speed the softening, flattening, and redness reduction of their scars. Time alone will help clear the scars, but these treatments can speed things along.

Edgar Franklin Fincher, MD, PhD
Beverly Hills Dermatologic Surgeon

October 26th, 2008

Patience is a virtue

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Unless you have an infection, you should be patient as scars of the uppr lids are usually the most imperceptible. Sometimes, if large amounts of skin is removed, there can be a noticeable transition between thicker skin of the upper part of the lid and the thinner skin of the lower part of the lid.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

July 4th, 2015

Should blepharoplasty scars be less evident by now?

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Hello! Thank you for the question! 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!
Lewis Albert Andres, MD

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

February 18th, 2013

Blepharoplasty scars at 5 weeks

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You are still early in your post operative course.  Scars need to go through a phase of maturation.  This can't be rushed.  Usually blepharoplasty scars heal well.  Keep them out of the sun if you can.  Please call your surgeon and let him/her know your concerns.

Learn more: http://www.jjrothmd.com/procedures/blepharoplasty-eyelift

Jeffrey J. Roth, MD, FACS

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

July 23rd, 2015

Scars following blepharoplasty

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Be patient for the scars to improve. Visible marks where the incision sites were at 5 weeks is quite normal. It can take up to a year for the scar to form what its final appearance will look like. Usually it barely perceptible. Make sure to wear sunglasses so that the scar does not become pigmented. 

Learn more: http://www.CosmeticEyelids.com

James R. Gordon, MD, FACS, FAAO
March 2nd, 2014

Healing timeline for eyelid surgery scars

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 Patients heal differently depending upon the skin type after a upper blepharoplasty. Most patients go through a "red and lumpy bumpy phase" for the first 2-3 months after the procedure. Once patients have gotten through this phase the incision turns to a fine little white line which is placed in the upper eyelid crease. Best  to check with your original surgeon for a postop followup. For many examples of blepharoplasty, please see the link below

Learn more: http://www.eyelids.com

William Portuese, MD

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 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.