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

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.

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 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. 

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. 

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.

I, too, do not like the expression "wing out".  The incision needs to be what is needs to be in order to correct your upper eyelids.  No well trained plastic surgeon is going to make the incision longer than necessary but shortening it will not produce the appropriate result. Eyelid skin heals very nicely.  I would strongly suggest that you speak with your plastic surgeon and not a pre-op nurse so that your concerns can be alleviated.

The incision for an upper blepharoplasty  must extend laterally as far as excess  skin is located. If the incision stops short there will be " pleat" of extra skin in the lateral corners of the eye. For many examples, please see the link below to our eyelid surgery  photo gallery

It is rare that an upper blepharoplasty incision can be limited to just the eyelid. The lateral sub-brow area also heals exceptionally well and you should not have any problem with the scar.