Desperately need to fix the problem!
I had ptosis surgery to my right eye.
In my first surgery, I only had the levator muscle elevated.
I had revision surgery 6 months later to remove excess skin.
In my opinion my surgeon didn't remove enough.
He also only did a partial incision (with laser) on my old scar so now I am left with
pinch skin in the inner corner and a big thick white scar.
Am I able to have blepharoplasty to fix this issue?
If so, am I able to see a regular plastic surgeon or do I need to go to an oculoplastic
surgeon?
Thank you for your question!
You've submitted some photos and you described in your question that you had levator muscle
surgery for ptosis and after that procedure you underwent a type of blepharoplasty to
enhance further the appearance of the skin of the eyelid.
And in one photo with the eye looking down, you showed the incision line and you described
the scar as being thick and other things and you want to consider treatment.
You asked a question of whether or not to have the revision done by a plastic surgeon
versus an oculoplastic surgeon.
Well, first in reviewing your photos, with your eyes open, it appears that the objective
of making the eyelid elevated and getting relative symmetry as well as shape and contour
appears to be achieved.
And that it obvious with your eyes looking down, that there is a difference with your
eyes closed.
Now, the question you first have to answer is why wouldn't you go back to the original
surgeon.
If the procedure has been accomplished to the point where the initial issue of ptosis
has been corrected, and when we measure success with ptosis, we measure height, contour, aesthetics
and symmetry.
And so, in the normal population, if the eyelids are one to two millimeters of each other,
it considered to be normal and normally doesn't draw attention.
So, again with your eyes open, it appears that you achieved your objective and I know
that anyone who look at your eyes would probably agree that eyelid height relative to the pupil
is where you wanted it to be after ptosis surgery.
Given that and the unique skills of an oculofacial plastic surgeon, I think that your best bet
is continue communicating with your doctor who did the original surgery.
If you're concerned about extra skin, well, your original surgeon knows whether or not
that's the case.
Sometimes, the folds and variability and the appearance is not a function of excess skin
but rather the function of the skin being attached or folding in a certain way.
An example is like a non-incisional Asian eyelid surgery.
This is a procedure where it may appear overlapped of skin when actually there is no extra skin
but rather the skin has to be attached in a way so that the eyelid crease can form.
Variation of this procedure is done for ptosis surgery when it is appropriate.
So, my first piece of advice is continue communicating with your original oculofacial plastic surgeon.
This is the doctor who know your eye very well and I'm sure has reasons for doing the
procedure the way it was done.
In choosing revision procedures, you may want to consider some procedure just to improve
the scar quality.
In our practice, we actually use a material called platelet-rich plasma which is drawn
from your own blood to help scars that are very thick and we have found this to be very
helpful in softening scars.
Now there was no clear indication from your question as to the time frame.
When we think of eyelid healing whether it's skin or muscle, we have to think of 6 months
to a year and not just a few months.
So especially in eyelid surgery, an undesirable scar can change over the course of a year
so you may want to do some conservative options until considering another surgery.
Again my advice is to meet with the original doctor and discuss your options then consider
second opinions if you don't feel as confident about the recommendations.
So I hope that was helpful, I wish you the best of luck and thank you for your question!