Upper Blepharoplasty Scar Healing Problem?

I had an upper blepharoplasty done 15 weeks ago. The scars are still bumpy, and on one lid, there's a prominent red bulge. I've been massaging and using Dermatix (30 days so far), as directed by my doctor, but it doesn't seem to be getting any better. Should I be concerned at this point? I did not have dissolvable sutures.

Doctor Answers 21

You have suture cyst

 Please ask your doctor to revise the scar and to remove the cyst. This not rare but will not go away by itself. If your doctor does not want to treat this ,find another surgeon.

New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Your surgeon needs to be more aggressive

The upper lid is the best scarring area of the body. Most patients look great even after a week. Although all scars can become reddened this usually occurs around the 4 week mark. I agree with the other surgeons that this red area is an inclusion cyst, small stitch reaction from a deeper stitch or if this has been enlarging rapidly could be a pyogenic granuloma (unlikely).

Some lesions will do well with a tiny amount of steroid. Or this scar may just need a minor revision to improve it. Either way have your surgeon address this more aggressively

Christopher L. Hess, MD
Fairfax Plastic Surgeon
4.4 out of 5 stars 33 reviews

While the scar is more reddened than usual, it should resolve with time

While the scar is more reddened than usual, it should resolve with time.

I have found it often responds nicely and heals quicker with treatment with a vascular laser, such as a 532 or 1064 laser that helps to lessen the redness and cause quicker scar resolution. A lot of physicians carry that type of laser in their practice.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

This is not normal healing

At 15 weeks after upper bleph your scar should be almost invisible.  You might have a cyst in the incision and you should go right back to your surgeon for an evaluation.  You will almost certainly need something done to this scar.  Good Luck!

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Firm nodule in blepharoplasty scar

I would agree with the comments of others made here. It is not uncommon to have an inclusion cyst along the suture line. Occasionally, these get inflammed and other times they get infected. Treatment typically consists of evacuating the cyst.

Alternatively, it could be an inflammed nodule that would benefit from steroid injection.

Seek the advice of your surgeon and proceed with his/her recommendations.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Ask your doctor what he will do if it does not improve.

It is important to keep good communication with your surgeon and let him know how your healing is progressing. Massage is good, but if it doesn't seem to be improving, you will want to let him know. Time may be all you need. However, I recommend that you find out what your surgeon will do if the incision does not improve and what the time fram will be. It will help to put your mind at ease if you know what to expect.

Thomas T. Nguyen, MD
Orange County Plastic Surgeon
3.9 out of 5 stars 19 reviews

Upper Bleph Scar, Consider Kenalog

Hi Nancy,

The only thing that I would add to the excellent comments of the other physicians is speaking to your surgeon about the possibility of a very dilute and very small quantity of a steroid injection (0.02-0.05 cc of Kenalog-10) directly into the scar tissue.

I hope that your scar resolves quickly.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

By 15 weeks, blepharoplasty scar should be quiet

Dear Nancy,

We don't have pictures but by this time frame, the bleph scar should be quiet even if the doctor had used absorbable stitches. Still, it is quite common to develop a small incision cyst along the bleph incision. This represents a small bit of surface skin that gets trapped below the skin surface. The skin element grows and gets walled off to form a small cyst. If you do have these, they typically do not go away on their own but require a small office procedure to remove.

This type of procedure is generally so minor that it does not qualify as a revisional procedure. There is typically very little down time. The red bulge is numbed and excised. When these cysts are quiet, the skin can be just cut open with a small needle and the cyst expressed. Contact you surgeon and ask for the nodule to be removed. Alternatively, an oculoplastic surgeon in your area can address this issue. Find such a specialist in you area by looking on the ASOPRS.org web site.

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

Bleph Scar Bulge

Thanks for your question Nancy -

That bulge may be an absorbable suture that is disolving.  You should ask your surgeon if they used any dissolving suture (in addition to discussing your concerns about the healing).

At 15 weeks your incision should be faint, thin and not red.

I hope this helps.

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 49 reviews

Excise the lesion

Often a scar gets worse before it gets better. Although in your case it appears from the photograph that you have an inclusion cyst. Simple excision and closure will treat the problem and you'll be on your way to recovery. 

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 140 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.