What Technique Can Be Used to Minimize Scarring Following an Eyelid Surgery?

Doctor Answers 6

Proper Asian Eyelid Surgery Technique to Minimize Scarring & Downtime

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Proper Asian Eyelid Surgery begins with a design which is drawn prior to the procedure. I have seen many Asians who have had eyelid surgery are not happy with have scars which go outside the natural crease and are difficult to manage. Asian eyelid anatomy is unique. Planning the shape of the crease is critically important. After making an incision with a scalpel or laser, I perform Asian blepharoplasty using surgical scissors to remove the skin. In Asian blepharoplasty the fat prevents a crease from forming properly. Using the incisional technique, I open the septum to allow the fat to come forward. Once the fat has come forward, a specific amount is removed. It’s very important to leave enough fat behind to prevent a crease from becoming too high or create a hollow. After fat is reduced in Asian eye surgery, the levator aponeurosis is revealed. Proper attachment of the skin to this structure is critical to creating a crease or double fold. In Asian blepharoplasty, sutures are placed carefully with attachment to the levator aponeurosis thereby creating a double fold. At the completion of Asian eyelid surgery procedure, the sutures are placed. There is a small amount of swelling. Ice compresses are used immediately to minimize swelling up to 2 days.

New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Asian eyelid surgery and minimizing scarring after a procedure

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Asian eyelid surgery and minimizing scarring after a procedure. The first thing I usually recommend is prevention. A good closure of the eyelid skin during the procedures if helpful. I like to use small sutures like 7-0 prolene. Also closing the incision underneath the skin is another approach to avoid suture markings. After surgery, I would take care of the incision really well through wound care techniques. after 2 weeks I would consider silicone gel applied at night and sunscreen during the day.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Minimizing scarring after asian eyelid surgery

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There are different types of asian eyelid surgery which cause variable amounts of scarring. The least amount of scarring occurs when the technique of surgery leaves both sides of the incision level with each other so that there is no step-off. This technique works best on thin eyelids that don't require a lot of thinning out the area beneath the incision, and without deep set eye sockets. 

If you have either of these conditions, then a more reliable method of crease formation is required. You will need to thin out the skin below the incision line to defat it and also allow a firmer fixation of the skin. In that case, you will have a slight stepoff, which translates into a more visible scar. 

So yes, there are techniques to minimize scarring, and it depends on your anatomy as to which technique would be appropriate.

Charles S. Lee, MD
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 79 reviews

Minimize eyelid scarring

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  Usually, scarring after eyelid surgery is mild.  I am not sure if you are worried in advance of the procedure or if you already had it done.  I always advise my patients that scars will improve over time, and that how it looks at one day or one month is not how it will look after 6-12 months, especially if a scar cream is used.  Good luck!

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

It depends on where you are in the recovery process.

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If you are days out from surgery, then time is best because tissue swelling and normal inflammation increases the visibility of the healing wound edges.  Generally this calms down remarkably with time.  On the other hand if you are more than a month out from surgery and the eyelid scars are not to your liking, this is a much more significant and less common situation.  Here it is also important to distinguish from the upper and lower eyelids.  Upper eyelid scars tend to hide in the upper eyelid sulcus.  The lower eyelid incision under the eyelashes is visible to all.  If you are a month or more out, please bring your concerns to the attention of your surgeon.  There are treatments that can benefit unsatisfactory scars.  An assessment is really needed to determine why the scars are more visible than they should be.  Your surgeon may or may not agree with your assessment.  If they do agree, possible treatment may include scar revision, 5-FU treatment, eyelid massage, topical silicone ointment.  Generally steroids are avoided because they can damage the delicate eyelid skin.  Even this rule is sometimes appropriately broken depending on the precision issue.  Occasionally cysts develop in the healed eyelid incision that need to be opened or removed.  Your surgeon should be motivated to help you with these concerns.

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

What Technique Can Be Used to Minimize Scarring Following an Eyelid Surgery?

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If you have already had eyelid surgery, tincture of time is your best bet for improving the incisional scar. Other things to consider are scar gels and localized massage. Steroid injections can be reserved for more more stubborn scars.

Suzanne Kim Doud Galli, MD, PhD, FACS
Washington Facial Plastic Surgeon

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.