Can scars be avoided in cosmetic upper eyelid surgery? People considering cosmetic upper
eyelid surgery or upper eyelid blepharoplasty are often concerned about visible scars after surgery
they want to be assured that scars will not be obvious when their eyes are open or closed
as a specialist in all types of cosmetic eyelid surgery I’ll discuss how I apply science and art
to the planning of upper eyelid blepharoplasty to make upper eyelid incisions become
virtually imperceptible I’m Dr Amiya Prasad I’m a Diplomate of the American Board of
Cosmetic Surgery and I’m a Fellowship-trained oculofacial plastic and reconstructive surgeon
as an oculofacial plastic surgeon I specialize in all types of cosmetic eyelid surgery
ranging from upper eyelid blepharoplasty for hooded upper eyelids Asian double eyelid surgery
to create an eyelid crease as well as other eyelid surgeries not typically performed by
general plastic surgeons such as eyelid ptosis correction and lacrimal gland prolapse repair
I often perform revision surgeries to correct the work originally done by other doctors for example
I perform reconstructive upper eyelid surgery for conditions resulting from infection
or skin shortage from excessive skin removal or undiagnosed eyelid ptosis as well as other upper
and lower eyelid revision surgeries in upper eyelid surgery incisions are made for typically
three reasons one is to excise skin when there’s a need to form an eyelid crease such as in the case
of Asian double eyelid surgery two to remove or excise redundant eyelid skin causing hooding or
to access the fat and soft tissues under the skin responsible for excess volume in the upper eyelids
and three to gain access to the levator muscle that may be causing the drooping of the eyelids
when excision excising redundant skin particular attention is needed for people with darker skin
types now darker skin types includes olive skin in the Mediterranean skin type and a range of South
Asian and East Asian skin types as well as darker Pacific Islander to African origin skin types
designing the optimal placement of the upper eyelid crease incision
and determining the amount of skin to remove with minimal tension is critical if the crease incision
is too low too high or extended too far medially towards the nose and laterally away from the eye
the scar can be undesirably visible with the eyes open and closed when tension is too high when
closing an incision the scar can become too wide as well as too thick these principles can be very
well illustrated in Asian eyelid surgery and in upper eyelid surgery for people of African descent
I perform Asian blepharoplasty for people of Asian descent
for a defining and eyelid crease commonly referred to a situation where they have a
monolid the crease is created by first excising a thin strip of skin and fat that is reducing
fat that is preventing the formation of an eyelid crease i place sutures to connect the eyelid skin
to the levator muscle which is the muscle that lifts the eyelid the sutures are placed to close
the incision and where the sutures are placed is where the eyelid skin folds when the eyes are open
by blending the incision line where the eyelids would normally have a crease the incision line
camouflages very well in non-incisional double eyelid surgery no fat or skin is removed but
rather a suture is placed in the same area so the skin folds when the eyes are open thereby creating
natural looking eyelid crease when I perform upper eyelid surgery for people of African
descent I’m frequently asked about the risk of keloids as well as the visibility of these scars
the basic principles I mentioned earlier applies proper placement of the eyelid
crease incision and minimizing tension is critical to a successful outcome
in addition the choice of sutures and timing of suture removal is also important in our practice
we provide detailed aftercare instructions and we follow our patients very closely
like any cosmetic procedure the results of upper eyelid surgery is determined by the experience
and expertise of this surgeon performing the procedure
I can also attest to the value of having an artistic eye and at the risk of sounding too
dogmatic I can say that the margin between a successful result and complications can be
truly measured in millimeters I hope you found this information from my experience helpful
if you’re interested in recommendations for your individual situation you may contact
us through our websites or call our offices to schedule a consultation thank you