Thank you for your question!
You stated in your question that you had surgery on August of 2015 that you are unhappy with
and that you underwent revision surgery on October by another surgeon and now you’re
concerned about the outcome of that surgery where you feel that you have some tethering,
some bumps and irregularities and you don’t like the appearance and shape of your eyes.
Well, I certainly can give you some guidance as to what you’re going through.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon.
I practice in Manhattan and Long Island for over 20 years and revision eyelid surgery
is something I perform for patients who come from around the world with various issues
similar to yourself.
So without knowing all about the full details of your appearance prior to your first surgery
and what resulted to the surgery in August but I can certainly see from the photos that
your concerns are reasonable.
I think one thing that you have to at least understand is that eyelid surgery is much
more complicated than a lot of doctors make it to be.
There’s a lot of delicate tissue.
There are a lot of areas where things can require a certain amount of finesse, knowledge,
experience which is why there is a specialty called oculofacial plastic and reconstructive
surgery.
You could imagine someone who’s trained first in eye surgery and then specializes
in eyelid surgery for two years of fellowship after training in eye surgery first.
So that being understood, there are things that you do based on wound healing and wound
healing is a process that goes on for a year and even beyond.
The question that has to be asked is why do things look the way they do.
This is a question that has to be brought to the revision doctor.
If the doctor already feels that there is an indication for additional surgery, the
timing is important.
In my opinion, whenever a surgery is done, there are certain hard indications where you
definitely need to move in sooner rather than later and then there are certain times where
there is a room to wait but what I would like to do is if there is a surgery that needs
revision and it is within a few months of the previous surgery, to me the 3-6 month
point can sometimes be the optimal point.
Because at the 3 month point, there is less swelling and between the 4-6 month point when
there is more long term more developed scar tissue.
Now that being said, you have to also ask the question to the revision doctor is why
do things look the way they do, what happened, why did this happen and what can be done differently
to avoid a recurrence of these problems.
When I see patients who need revision surgery, it’s very common to have at least 5 operations
before coming to see me.
A lot of times doctors do things that are well intended but sometimes they don’t do
procedures that are necessary to get the desired outcome.
There are too many possible options to discuss in detail in answering this question in this
way but what I think what’s important to understand is talk to your doctor who did
the revision surgery about what the specific outcomes you want to see happen.
You mentioned the shape and that’s a very important part of the aesthetics of the eyes.
People will come to me and say that their lower eyelids are rounded.
They feel like they lost the character of their eyes.
They don’t look like themselves.
And if this is a problem for you, make sure you express this to the doctor who’s performed
the revision surgery and be comfortable and confident in their ability to deliver the
results.
The question I would ask is if the eyes looked pretty good after the revision surgery and
is what you’re experiencing now a result of the way the eyes are healing.
It’s kind of a golden rule in cosmetic surgery that if it doesn’t look good in the operating
room, it’s not going to look good outside the operating room.
So I think that you have the opportunity to discuss further the options and what could
happen and if you aren’t comfortable and confident with the doctor who performed revision
surgery then additional opinions can be sought out.
But, it’s also important to understand that when you meet different doctors, you will
get many different opinions.
Clinical medicine is like that.
There is a simple formula in everything and every surgeon, every physician brings to the
table not only knowledge from training but also knowledge from hands on experience.
And that’s why someone like myself, 20 years in practice, performing hundreds and hundreds
or surgeries every year, there’s a certain level of experience of the aggregate of over
20 years and I try to communicate that experience to my patients and help them understand the
predictability and the things that can go in one direction or another direction depending
on how they heal.
Monitoring healing is also very important.
It’s something that we do.
We also use a lot of regenerative technology where we use Acellular matrix and platelet-rich
plasma to optimize the results of your wound healing because a lot of times, when people
have revision eyelid surgery, they have a lot of scar tissue.
And a lot of times, when you operate on scar tissue, it may look good in the beginning
but it may result in more scar tissue and that itself has its own method of management.
So again, in summary, you want to talk to your doctor about getting the result in terms
of the shape and the details of what can be done differently to avoid the problems you’re
dealing with differently.
So I hope that was helpful, I wish you the best of luck and thank you for your question!