Upper Eyelid Scarring - Possible Revision / Treatment?

Hello, I have a few recent scars of about three weeks now. I know that I must give it a lot more time, but I am concerned more about the scar tissue preventing healing. It's red, hard,lumpy,and I am trying to massage it daily, along with kelo-cote and hot/warm compresses. The scar is above the left eye, near the eyebrow. Will the body break down the scar tissue completely or does it need revision? Thank you kindly for your time and advice.

Doctor Answers 9

Scarring Following Blepharoplasty

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It's not unusual for patients to have noticeable scarring in the immediate post-operative period following any type of eyelid surgery. It's important to realize that all incisions heal with some scarring, but the eyelid skin has unique qualities that tend to minimize scarring.

In the immediate post-operative period eyelid incisions tend to be red and raised. These scars tend to respond nicely to massage and avoidance of sun exposure. In the vast majority of cases, eyelid scars heal nicely with the passage of time. In many cases, these scars are imperceptible.

Rarely, hypertrophic scarring does occur following this type of procedure. Under these circumstances, gentle massage and rarely, steroid injections are helpful. It's unusual for patients to require scar revision following eyelid surgery.

It's important to maintain close contact with your plastic surgeon when hypertrophic scarring occurs. Your surgeon should be able to formulate a treatment plan that addresses your concerns.

Upper eyelid scarring

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When the skin is injured it recovers in a series of phases. Initially there is an inflammatory phase which involves immediate local cellular responses (first few days). This is followed by the proliferative phase which involves continued tissue healing, collagen synthesis, wound contracture, etc. Finally, at around three weeks, the wound enters the maturation and remodeling phase. This is where collagen formation and other reparative responses subside. Please note that any of these phases can be prolonged in events of infection, smoking, diabetes or other wound impairing processes. At this time your wound appears to be in the proliferative phase of healing where it is not uncommon to feel some level of scar production. Your wound will most likely become more violacious over the next 1-2 weeks and aesthetically appear at its worst. After this point the remodeling phase will become the dominant phase and the site will then begin to improve in appearance. You may need to follow with your doctor for dermabrasion or scar revision, but as you keenly stated more time will need to pass before additional interventions are undertaken.

Be healthy and be well,

James M. Ridgway, MD, FACS

James M. Ridgway, MD, FACS
Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 98 reviews

Eyelid surgery scar revision

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Revision eyelid surgery should be done at least 6 months after the initial surgery to allow time for healing and tissues to soften. Asymmetries, excess skin, fat rolls, fat malposition can all be improved. Other treatments may include laser or chemical peels to tighten skin and improve texture

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Scar revisions on eyelid

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These scars will take several months before they settle down and look better, but they will definitely  improve.  I would suggest massaging the scars several times each day.  You may want to apply a product like scarfade on the scar.  You could also choose to massage the scars with lanolin, Mederma or cocoa butter if you want  an alternative product to consider.  Scar revisions should not be considered until 6 to 12 months have passed.  The only reason to revise scars sooner than that would be if there was a functional loss or distortion to surrounding structures which is not seen in this picture.  Follow up with your local Plastic Surgeon for further opinions.


Good luck.

Eyelid scar tissue

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Yes, you are quite perceptive. It will take many months for the swelling and scar tissue to resolve a bit.  The scar may be able to be revised at that point.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Eyelid scar prognosis

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Your scar looks new and everyone who deals with these injuries will tell you the same thing.....wait!  Continue with your routine and possibly have your doctor inject a small amount of Kenalog, a cortisone type drug that often helps thick scars soften and shrink after being injected directly into the scar itself. A revision may be what you need but it should be done after the healing is settled. Ultimately I would expect you to get a good result either through natural healing or with the help of Kenalog or possibly later surgery revision (which is an easy procedure for any plastic surgeon).

When the scar is not red (about 5-8 months) is  the time to decide on whether a revision is needed. 

Harlow Hollis, MD
Victoria Plastic Surgeon

Upper Eyelid Scar Treatment with Kenalog-10

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Hi Alpine,

You can speak with your treating physician about the possibility of intra-lesional injections of the steroid Kenalog-10 to soften your scar.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Scarring after eyelid surgery

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While I know that waiting can be emotionally frustrating, the healing process can be a slow and often temperamental one. Unfortunately, being patient is really necessary prior to considering medical intervention. If you are really concerned, having a follow up with your surgeon might help ameliorate and hopefully alleviate some of your fears.

Andrew Kaczynski, MD (retired)
Sacramento Plastic Surgeon

Scars take time to mature

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Your scar is still very immature and it will take time for it to settle down. There are lots of ways to help scars mature, but ultimately time is your ally. Typically I recommend waiting 3-6 months before any revision surgery, except for unusual circumstances.

Lawrence Iteld, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 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.