Upper bleph scar too high? (Photo)

Question

I am six weeks post upper bleph procedure. I am concerned that the incision/scar placement is far too high. The nurse told me this will resolve over time and settle in to my natural crease...? At the time of marking for the procedure the Doctor assured me that the scar would be in my natural crease.

Adam D. Stein, MD · Answer

From what I can see your incision does appear to be higher than your eyelid crease. Although I expect the incision line will become less visible as the healing continues, I am not sure if I would agree with the nurse that it will ultimately end up in your eyelid crease.  Please attend your followup appointment and bring your concerns up with your surgeon.  Good luck with your recovery.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Kenneth D. Steinsapir, MD · Answer

Your photographs of the eyelids before surgery, show every sign of a partial levator disinsertion.  This means that your upper eyelid creases are not in a "natural" position.  The poorly defined crease you had before surgery should not have been used as a landmark.  Instead, the surgeon needed to place a crease where it needs to be, which in your eyelid, is not at 14 mm above the eyelashes, but perhaps 7-8 mm above the lash line.  So no, your incision is not in the "natural crease."  Also, the surgeon did not need to extend the skin incision outside the orbital rim.  Rather the surgeon could have taken advantage of eyelid structure to help the fold.  You now have PUBS-post upper blepharoplasty syndrome:  hollow upper eyelid, high or poorly defined crease, upper eyelid ptosis, lash ptosis, and a compensatory eyebrow elevation.  The bad news is that this is likely to look worse as you heal.  The good news is that this can be successfully revised.  The upper eyelid crease can be lowered and the ptosis can be repaired.  Generally, we wait about 6 months to make this repair but I recommend having a personal consultation well in advance of the 6 month mark to determine the appropriate time frame for you.

Curtis Wong, MD · Answer

as your scar is not in your natural crease and there has been a trend towards lower lid creases (

Mark L. Mazow, MD, FACS · Answer

From the photo is does appear that the incision was placed above your natural lid crease. I would see your surgeon or another fellowship trained surgeon, but at this point I would wait for all of the wounds to heal for several month before considering  a revision.

Upper bleph scar too high? (Photo)

Answers (5)

Answer: Would wonder what the credentials and experience were of your surgeon

Answer: Would wonder what the credentials and experience were of your surgeon

Answer: High lid crease post blepharoplasty

Answer: High lid crease post blepharoplasty

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Upper bleph scar too high? (Photo)

Answers (5)

Answer: Would wonder what the credentials and experience were of your surgeon

Answer: Would wonder what the credentials and experience were of your surgeon

Answer: High lid crease post blepharoplasty

Answer: High lid crease post blepharoplasty

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.