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.
Upper Blepharoplasty Scar Healing Problem?
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.
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
Incisions on upper lids undergo lumpy-bumpy phase
The incisions on the upper lids tend to undergo a lumpy-bumpy phase one to three months after the surgery. All of this phase tends to settle down where the lumpy-bumpy pink incision will turn to a fine little white line hidden in the natural crease. On rare occasions, a small milia may turn into a pimple right at the incision line, and this needs to be expressed with a small needle and Q-tips.
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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.
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!
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.
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.
Upper Bleph Scar, Consider Kenalog
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.
By 15 weeks, blepharoplasty scar should be quiet
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.
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.