Late 60s, upper bleph - what is the cause of the continuous red bumps? How to get rid of them? (Photos)

Question

Asian female skin type, late 60s, lower blepharoplasty healing well but the uppers have been a huge struggle. Surgery was in August. Had injections done twice already but nothing seems to help, new blood blisters keep coming back, and the inner corners of both eyes are raised and bumpy. Been keeping the lids moisturized with 2 scar gels (one is allantoin based, one is silicone).

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Hello,

I'm sorry to hear about the challenges you're experiencing following your upper blepharoplasty. Continuous red bumps and blood blisters can be concerning, especially when healing does not progress as expected. Here are some potential causes and suggestions for management:

Suture Reactions:
Sometimes, the skin can react to sutures used during surgery, leading to irritation and the formation of bumps.

Scar Tissue Formation:
Raised and bumpy areas could be due to hypertrophic scarring or keloids, which are more common in certain skin types.

Infection or Inflammation:
Persistent redness and bumps may indicate an underlying infection or inflammation that requires medical treatment.

Allergic Reaction:
It's possible to have an allergic reaction to topical products or materials used during surgery, contributing to skin irritation.

Blood Blisters:
These could result from minor trauma or friction during the healing process. Managing these carefully is important to avoid further irritation.

Suggestions for Management:

Consult Your Surgeon:
It's essential to discuss these symptoms with your surgeon. They can provide an accurate diagnosis and appropriate treatment, possibly including different medications or interventions.

Consider a Dermatologist Consultation:
A dermatologist may offer additional insights or alternative treatments, such as laser therapy or steroid injections, if scarring is a concern.

Gentle Skincare Routine:
Continue with a gentle skincare routine, avoiding harsh products. Ensure that any moisturizers or scar gels used are suitable for sensitive skin.

Monitor for Infection:
Watch for signs of infection, such as increased redness, warmth, or discharge, and seek medical attention if these occur.

Alternative Treatments:
Your healthcare provider might suggest other treatments like oral medications or different topical agents to reduce inflammation and promote healing.

I hope this information helps guide you towards resolving these issues. Wishing you a smooth recovery ahead.

Best regards,

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