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.
Upper Eyelid Scarring - Possible Revision / Treatment?
Doctor Answers 9
Upper eyelid scarring
Be healthy and be well,
James M. Ridgway, MD, FACS
Scarring Following Blepharoplasty
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.
Eyelid surgery scar revision
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Scar revisions on eyelid
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.
Eyelid scar tissue
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.
Eyelid scar prognosis
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.
Upper Eyelid Scar Treatment with Kenalog-10
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.
Scarring after eyelid surgery
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.
Scars take time to mature
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.