How Can My Blepharoplasty Scars Be Improved?

Q: Dr. Eppley, I am writing to seek your expert advice regarding a challenging situation I’ve been facing with my blepharoplasty results. I initially underwent the procedure with an American surgeon, who informed me that scarring was inevitable. However, I was not prepared for the outcome of developing atrophic scars.

To address these concerns, I opted for a revision blepharoplasty with an oculoplastic surgeon in the UK. Unfortunately, the results were not as I hoped. While one scar has widened and atrophied worse than before, the second scar was traumatized when it reopened, leaving it very wide and aesthetically displeasing. Despite undergoing laser treatments for the past year, I have not seen any noticeable improvement.

This situation has left me feeling extremely self-conscious, and I am unsure of the best way forward. I would greatly appreciate your professional opinion on potential solutions for these scars, as well as any recommendations you might have for improving their appearance.

Thank you in advance for your time and expertise. I look forward to hearing from you.

A:The success of almost any scar revision depends on how much loose tissue is present and the laxity of the surrounding tissues. When wide scarring develops after an excisional procedure (now loee of skin)  in a limited space area (e.g., the eyelid) the success of a scar revision is going to be limited and could even make the scars worse. You have unfortunately proven that concept by the revisional surgery you had. While unpleasant and unsatisfying the surgical motto of… past behavior is a good predictor of future performance...should be well heeded. Or to phrase it another way as another surgical motto….if it was an easy problem to fix it would be so by now. While I think the revisional surgery was worthy of trying, its outcome tells you that for now anither revision is not going to work. In time with the benefit of aging and the creation of more and relaxed tissues another scar revision could actually be successful.

Dr. Barry Eppley

World-Renowned Plastic Surgeon