I will soon have an upper bleph with removal of skin only. I'm concerned about the phrase "Your incision will 'wing' out"

Question

The pre-op nurse said I will have the incision at my eye crease but will then have a wing on the outside of my eye to prevent hooding. I am 43 and have small amount of skin that needs removing. The wing out comment scares my because I was originally told you wouldn't see my scar when my eyes are open. Any thoughts or comments.

Nelson Lee Novick, MD · Answer

Over fifteen years ago, I developed a minimally invasive technique for treating dermatochalasis, the fancy name for the excess skin that sags over the upper eyelid from some degree of brow ptosis. In my experience this technique has proven a very viable alternative to surgical blephs, especially in younger individuals without excessive excess skin.The technique is quite simple in experienced hands and literally takes about five minutes per side to complete. The "underbelly" of the excess skin (the part hidden from view) is first anesthetized with local anesthetic--making the procedure painless. Next, the focal areas to be treated are marked in a discontinuous fashion--not in a continous line-like fashion. Finally, a simple cautery is then used to treat these focal areasAlmost immediately, the skin contracts vigorously in response to the probe, drawing the hooded portion of the lid backwards and upwards over the surface of the underlying normal lid. As it does so, the underlying eyelid is exposed and restored. Each wound is then covered with only a small amount of antibiotic ointment and left to heal spontaneously. The discontinuous, focal, nature of the little wounds typically leaves barely visible marks when completely healed--very much like when a dermatologist removes keratoses or skin tags from the upper lids in this fashion.Healing is usually complete in seven to ten days. Slight bruising and mild swelling are common afterward and may take about a week before becoming less noticeable. Cold compresses can be used in the first 48 hours to minimize the bruising and swelling. This may be supplemented by the oral use of bromelain for three days. Bromelain, an enzyme, is a pineapple derivative that has demonstrated usefulness in preventing bruises and speeding their resolution. Pain medications are seldom necessary, but for some people who experience mild discomfort, acetaminophen (Tylenol) is ordinarily adequate. Most people can return to work the following day. I performed the procedure on myself a number of years ago standing in front of a mirror and hours later took a twelve hour transatlantic flight.One treatment is ordinarily all that is required. The results are permanent and can be fully appreciated in just two weeks. When completely healed, faint, narrow, linear ivory or off-white lines are often all that can be seen at the treatment site, which are not visible when the eyes are open.

Stephen Prendiville, MD · Answer

I personally think that the term "wing out" is a poor and scary description for the way the incision is placed in an upper eyelid blepharoplasty.  The lateral extent of the incision is determined by the amount of skin that needs to be removed to obtain aesthetic benefit.  If a patient has significant lateral hooding, the incision must extend further than if minimal skin excess is present.  In the majority of scenarios and despite the length of the incision, upper blepahroplasties typically heal very well.

Frank P. Fechner, MD · Answer

Many facial cosmetic surgeons use this extended incision for improved outcome. In fact, frequently I would consider this outer aspect of the skin reduction most essential. Luckily, the incision heals very well in this area but may stay slightly pink for a few weeks. Make up will help during this healing phase. Discuss your concerns with your facial surgeon. Maybe he can even demonstrate representative photos to ease your concerns.

Richard L. Zeff, MD · Answer

Sometime unexplained terms can be scary.  A similar term used often by plastic surgeons is "dog ears".  When removing skin for any reason, it's important to be able to close the incision smoothly and not leave any bunching at the ends. This sometimes results in a slightly longer incision than expected, but if placed correctly and done well, it generally results in a barely visible scar in the long run. So "Wing out" is a scary way of telling you that the scar will be slightly longer but probably just fine.

Houtan Chaboki, MD · Answer

The upper eyelid incision after blepharoplasty heals very well. Most don't notice the incision at all, once appropriately healed. The lateral or "wing out" extension is commonly necessary to remove an adequate amount of skin. Some patients, however, don't need this extension or longer incision. A plastic surgeon will tailor the incision length and amount of skin excision dependent on your anatomy and personal goals. Speak with you eyelid plastic surgeon regarding any concerns you have.Best,Dr. Chaboki

I will soon have an upper bleph with removal of skin only. I'm concerned about the phrase "Your incision will 'wing' out"

Answers (8)

Answer: Wing out

Answer: Wing out

Answer: Upper eyelid incision length for blepharoplasty

Answer: Upper eyelid incision length for blepharoplasty

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Everything you need to know about Eyelid Surgery

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I will soon have an upper bleph with removal of skin only. I'm concerned about the phrase "Your incision will 'wing' out"

Answers (8)

Answer: Wing out

Answer: Wing out

Answer: Upper eyelid incision length for blepharoplasty

Answer: Upper eyelid incision length for 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.