Eyelid Surgery Complications: Thickness, Scarring, and Healing

My eyes feel strange?

Hello, doctor! I had double eyelid surgery last year, but I still ended up with inner double eyelids.
So, I asked the same surgeon to perform the procedure again.
Immediately after the surgery, I noticed a difference in the thickness of my eyelids (the left eyelid is thicker).
I asked my surgeon about it, and he said that it's normal for the thickness to vary right after surgery and that it would equalize as I heal.
However, it has been over two months now, and while the swelling has significantly reduced, one side is still thicker.
Additionally, the thicker eyelid appears more droopy.
The doctor mentioned that it would normalize after the swelling subsides.
Is this normal? Will it really go away?
Also, my first surgery left a nice, faint line (around two stitches), but this time the incision (which involved eyelid revision) has a straight line of stitches that are red and slightly crooked.
There are also some small bumps forming along the stitches.
Could this be keloid formation? Will it go away? The scar is quite noticeable; is there any medication I should apply? Thank you!

*Shǎguā*, 10~19 year old female. Ask Date: 2005/09/24

Dr. Lu Daokuan reply Plastic Surgery

The healing process for a second incision will naturally be slower than for the first one.
Generally, it takes about 3 to 6 months for it to heal well.
You can use an eye cream containing Vitamin C for care.

Reply Date: 2005/09/24

More Info

Eyelid surgery, commonly known as blepharoplasty, is a popular cosmetic procedure aimed at enhancing the appearance of the eyelids. However, like any surgical procedure, it can come with complications and concerns regarding healing, scarring, and overall aesthetic results. Based on your description, it seems you are experiencing some common post-operative issues, including uneven eyelid thickness, potential scarring, and concerns about healing.

Firstly, it is not uncommon for patients to notice differences in eyelid thickness immediately after surgery. Swelling is a natural part of the healing process, and it can take several weeks to months for the swelling to fully subside. In your case, since it has been over two months since your second surgery, it is reasonable to expect that the swelling should have decreased significantly. However, if one eyelid remains thicker than the other, it could be due to several factors, including uneven healing or the way the tissue responded to the surgical intervention.
Your surgeon's reassurance that the eyelids will normalize over time is generally valid, as many patients see improvements in symmetry as the healing progresses. However, if the asymmetry persists beyond the typical healing period, further evaluation may be necessary. It’s essential to maintain open communication with your surgeon about your concerns, as they can provide tailored advice based on your specific situation.

Regarding the appearance of your scars, it is normal for surgical scars to appear red and raised initially. The presence of small, raised areas on the scar could indicate the formation of hypertrophic scars or keloids, which are types of abnormal scar tissue. Hypertrophic scars are raised but usually improve over time, while keloids extend beyond the original wound site and may require treatment. If you suspect that you are developing keloids, it is crucial to consult with your surgeon or a dermatologist for an accurate diagnosis and potential treatment options.

To promote optimal healing and minimize scarring, consider the following recommendations:
1. Scar Management: Use silicone gel sheets or silicone ointments, which have been shown to help flatten and soften scars. These products can be applied once the incision has fully healed.

2. Sun Protection: Protect your scars from sun exposure, as UV rays can darken scars and make them more noticeable. Use sunscreen with a high SPF on the scarred area when exposed to sunlight.

3. Moisturization: Keeping the scar moisturized can help improve its appearance. Use a gentle, fragrance-free moisturizer or ointment.

4. Avoiding Irritation: Be cautious with any products you apply to the area, as harsh chemicals can irritate the skin and worsen scarring.

5. Follow-Up Appointments: Regular follow-ups with your surgeon are essential. They can monitor your healing process and recommend additional treatments if necessary.

If you continue to have concerns about the thickness of your eyelids or the appearance of your scars, it may be beneficial to seek a second opinion from another qualified ophthalmologist or plastic surgeon who specializes in eyelid surgery. They can provide insights into whether your healing process is typical and suggest potential interventions to improve your results.

In conclusion, while some asymmetry and scarring are common after eyelid surgery, persistent issues should be addressed with your healthcare provider. With proper care and attention, many patients experience significant improvements in their surgical outcomes over time.

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