Thank you for your question.
You submitted several photos and you’re asking, how long does it take for upper eyelid
scars after blepharoplasties to fade.
And you stated in your question you’re putting Kelocote on your upper eyelid twice a day
and you’re looking for some guidance as to what the timeline is from where you are
currently.
Well, I can certainly give you my impression based on the photos you submitted of course
without the benefit of any history and physical examination.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Eyelid surgery or upper eyelid cosmetic and reconstructive surgery has been a significant
part of my practice.
And certainly, I have a lot of experience that I actually published about the best ways
to handle different skin types when it comes to these types of issues.
So when I look at your photos, I noticed that you have some bruising and you have some yellow
discolorations which makes me think that the eyelid surgery was relatively recent.
And when I say relatively recent, I’m thinking maybe in the past few weeks.
Well, I think this is a discussion that you definitely should have with your doctor.
When I talk to my patients, and again, coming from decades of experience and knowing what
people do, I very often have to discourage or dissuade them from trying to prevent some,
what they’re always concerned about, is keloid formation.
One of the fears everyone has is that the scars would look thick and obvious.
So part of this is understanding what is going on.
Wound healing is a very important concept.
And essentially, to make it simple, when you are within the first month of your wound healing
process, it is actually normal for the skin of the eyelid incision point to actually be
elevated and thick.
And many times, many people want to do something to interfere with that.
And what unfortunately happens is by placing their fingers and whatever they’re placing
on there, they actually often inflame it further.
Essentially, the phase you’re going through is what is often referred to as the proliferative
phase of wound healing.
During the proliferative phase of wound healing, the body is essentially putting collagen and
that collagen is relatively disorganized.
We are kind of like throwing spackle.
It’s basically repairing and all of the fibers of collagen are actually disorganized.
Now after one month, they start going through a remodeling phase and during that phase,
those disorganized fibers become parallel and flat.
And so, a lot of times, the fear of the scar becoming a keloid occurs during this proliferative
phase when things look a little bit thick.
So I follow my patients pretty closely.
I see them at one week, sometimes at 2 weeks after that first week timeframe, after they
had sutures removed then at one month then 3 months, 6 months a year.
That first few weeks is very important to just essentially, what I tell my patients,
is to do proper hand hygiene, avoid touching the areas as much as possible and simply,
just try not to put any kind of anti-scar cream or anything like that.
In my experience and I’ve written lots of articles about this such as an article I wrote
years ago called “Ethnic Considerations in Eyelid Surgery”, even people with darker
skin who have this tendency to form keloids, whether it’s keloid behind the ear where
ear piercing or hypertrophic scars or thick scars where they show incisions in their abdomen
or other areas, well our skin is remarkably forgiving.
When there is good technique and good closure, even in keloid prone skin, our skin can heal
very nicely.
So I think that you should remember that your timeframe is not in the first few weeks but
actually over several months.
And over several months, you will see this remodeling process.
And again, with follow-up with your doctor, you should have a much better understanding
especially if your doctor shows you progression of your improvement with time.
And of course, this is something that you should always ask your doctor about before
you go and place things on your own.
So I hope that was helpful, I wish you the best of luck and thank you for your question.