can eyelid surgery be done on dark skin prone to keloid scars people with dark
skin such as those of African and Hispanic Mediterranean and Asian descent
are often concerned about having eyelid surgery because of the possibility of
undesirable scarring such as scars referred to as keloids although it is
well-established that people with darker skin types are more prone to these types
of scars I can speak to how I approach upper and lower eyelid surgery for
so-called ethnic skin types like mine in my practice I'm Dr. Amiya Prasad I'm a
Board-certified cosmetic surgeon and Fellowship trained oculofacial plastic
and reconstructive surgeon I've been in practice in Manhattan and Long Island
for over 20 years I did my residency in ophthalmology in Brooklyn I also worked
as a division chief of oculoplastic surgery for many years in the same
hospital after my oculoplastic surgery training we served a community of mostly
people of African heritage else well as a large Hispanic and Caribbean
population during this time I also became known for Asian eyelid surgery
both primary and revision surgery performing cosmetic eyelid surgery as
well as a wide range of facial trauma related surgeries including lacerations
and fractures which provided me with the foundation of experience that inspired
me to help my colleagues understand some important aspects to performing eyelid
surgery in non-caucasian patients with this purpose in mind I wrote an article
titled ethnic considerations in eyelid surgery to avoid scars my first
principle is if you can avoid an incision than do that
for example my approach to lower eyelid surgery to reduce under-eye bags
regardless of skin color and skin type is using the transconjunctival method
this means for a person who has puffy under eye bags caused by fat pockets
which have herniated forward I perform a surgery from the inside of the eyelids
which means there are no external or outside incisions on the lower eyelid my
objective is to help you look like you never had eye bags or eyelid surgery the
art is to preserve the natural shape and character of the eyes upper eyelid
surgery does require the removal of skin which means an external incision is
necessary as well as the placement of sutures when it comes to upper eyelid
surgery there are also some more specific considerations for different
ethnic groups for example in asian eyelid surgery the level of the crease
and the options of non-incisional in versus incisional as well as the type of
epicanthal fold and whether fat should be removed makes this type of surgery a
specialty area within my specialty practice I have found that people who
have the highest risk for keloid scarring still can have upper eyelid
surgery performed safely I explain to my patients with skin types ranging from
light olive skin to dark brown skin that there are some things that are important
to do to minimize the risk of undesirable scarring the design of the
upper eyelid skin removal is critical we want to avoid an incision line which is
obvious outside of the eyes when the eyes are open the tension of the skin
closure should be minimal and the sutures and suture techniques are
critical to creating a fine line well hidden inside the natural upper eyelid
crease I routinely perform both upper and lower
eyelid surgery using local anesthesia with LITE intravenous or IV sedation so
patients are comfortable and can recover from surgery much faster than they would
with general anesthesia typically my patients return to work in about a week
in the early to mid 90s I believe very strongly in making cosmetic eyelid
surgery more accessible to everyone many people came to me feeling confident
that as one of a very few specialists in oculoplastic surgery of indian-origin at
that time in the tri-state area that because of my own skin type I would have
some insight in the concerns of patients with darker skin certainly this had some
validity but my training and subsequent experience was the foundation to my
approach to customizing eyelid surgery for all people regardless of ethnicity I
hope you found this information helpful thank you for your question
you