Revision Blepharoplasty Surgery
The upper eyelids and our eyes are the focal points of our faces. When we look at others, we focus directly on this part of the face, and our eyes can easily pick up on asymmetries or differences in the eyelids. Eyelid surgery is a nuanced, unforgiving subspecialty of plastic surgery and it can go wrong in many ways. Dr. Dewan’s entire professional career has been devoted to eyelid surgery and he has significant experience in revision surgery. The best way to avoid revision surgery is to see a surgeon who specializes in eyelid surgery.
What makes revision surgery difficult?
Whenever we have eyelid surgery, our bodies take up to 6 months to heal. Part of this healing is to form scar tissue internally. As scar tissue forms, it is made of thick, firm material, as well as small blood vessels. This scar tissue fundamentally changes the anatomy of wherever it forms. When a patient requires revision surgery, it is up to the surgeon to navigate through this scar tissue in order to accomplish the surgical goals. Scar tissue makes this more challenging by having increased bleeding, and making it more difficult to find the normal anatomical landmarks that surgeons use to safely perform surgery. Additionally, the presence of scar tissue changes how the normal skin and fat lie after surgery. This means that revision surgery is always more unpredictable compared to a first-time operation.
How much improvement can you make with revision surgery?
The most important aspect of revision surgery is your consultation. During your consultation, Dr. Dewan will discuss your surgical history, aftercare, and your current goals. He will also perform a thorough exam and then provide you with recommendations to improve your eyelids. Revision surgery is challenging and Dr. Dewan will provide realistic goals and outcomes. Ultimately, scar tissue and prior surgeries may limit your final results, but the goal is always to move toward improvement, and generally make your eyes more symmetric.
Can I have other procedures performed at the same time?
There are many procedures that can be performed at the same time to enhance the overall effect of the revision surgery. These include:
- Lower eyelid blepharoplasty:In many cases, performed a rejuvenating procedure to reduce the tired, lower eyelid “bag” can help your overall appearance and also “hide” any asymmetry from the upper eyelid revision.
- Ptosis repair:Occasionally, upper eyelids are left hanging too low over the eye. When a revision is performed, it may include lifting the eyelid to achieve a more symmetric look.
- Brow elevation: Elevating the brows can provide a more “open” appearance and hide extra folds or asymmetries from revision surgery.
- Eyelid lesion removal:In many cases, small growths or eyelid bumps are present along incision lines from prior surgery. During a revision, removing these scar cysts is necessary to achieve the best results.
Is there scarring seen in the eyelid after surgery?
Revision blepharoplasty most commonly uses the same blepharoplasty incision you had made in your previous surgery.
- Generally, Dr. Dewan’s approach is to hide this incision by creating a new eyelid crease for you at the site of this incision.
- During surgery, Dr. Dewan also tries to remove as much previous scar tissue as is safe, hopefully limiting any visible thick scars in the eyelids.
- Because the incision line is usually the location of your new eyelid crease, Dr. Dewan will also place special stitches to re-form the crease, which helps give a more defined and symmetric appearance to the lids.
What is the recovery like?
Most patients describe recovery from revision blepharoplasty as similar to the recovery from their initial surgery. That said, because of the previous scar tissue, most patients have more swelling and bruising with the revision. This swelling is treated with lots of ice packs. Post-operative pain is mild, with pain medicine such as Tylenol all that is necessary to treat it. When you are comfortable, you are free to do most of your routine daily activities. Showering is possible the morning after surgery, and other than exercise, most activities can be performed as you would normally. Dr. Dewan prefers to use dissolving stitches and they will go away on their own in about 10 days. He will also schedule a post-operative visit for you 1 week following surgery.
Before and After
Our before and after photos are from right before the surgery to about 5-10 days after. All our photos are unretouched. You can expect additional improvements for several weeks after surgery, and most patients are so happy with their surgeries that they don’t come in after the immediate post-operative visit (though we always are happy to see them).
Will insurance pay for this?
Revision blepharoplasty is only covered by insurance if your eyelids are covering your eye and blocking your vision. During your consultation, Dr. Dewan will measure your eyelid position perform a visual field to determine to what extent your vision is being blocked. These measurements will then be sent to your insurer, and if you meet their criteria, your insurance will cover the revision blepharoplasty. In most cases, however, revision blepharoplasty is meant to restore the cosmetic appearance of your eyelids and is, therefore, not covered by insurance. Dr. Dewan will provide a quote for surgical fees during your consultation.
An oculoplastic surgeon will give you
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the best results.