Eyelid surgery is arguably the most delicate of any plastic surgery procedure for several reasons. For one thing, eyelid skin has different properties from other skin in the body. It is the thinnest in the body and it has no fatty tissue underneath. This allows the eyelids to move freely with each blink. Eyelid skin is also very elastic, a property that allows the eyelids to protect the eye in case of trauma. These characteristics of eyelid skin make the healing process a little bit different from other areas of the body. An eyelid incision will usually heal better than a chest incision. However, unlike a chest scar, the smallest distortion on the eyelid skin will be visible to most people.
Good postoperative care of an eyelid incision is essential to guarantee an imperceptible scar after surgery. The surgeon is responsible for handling tissues with care and making sure that the incision is performed flawlessly. On the other hand, the patient is responsible for takin care of the incision after the operation. The final appearance of the scar will largely depend on the patient’s ability to care for the incision during the first postoperative month. A good surgeon will clearly communicate postoperative care instructions and expectations to his patients.
Caring for your eyelid incision after surgery
Eyelid incisions are very delicate but you should not be afraid to follow your surgeon’s instructions regarding cleaning and the application of topical medications. The type of care will depend in part on the kind of suture used to close the incision. These sutures can be absorbable or non-absorbable. Absorbable sutures have the advantage of not requiring removal but they tend to cause inflammation in the site of the incision which may result in a more visible scar. For this reason, these sutures are usually avoided in patients who heal poorly, such as patients who form keloid and those from African an Asian descent. On the other hand, non-absorbable sutures tend to cause less inflammation but they must be removed 5 to 7 days after the procedure. Regardless of the type of suture, you need to carefully wash the incision twice a day with a mild soap and follow with the application of antibacterial ophthalmic ointment. This ointment is generally provided by the surgeon and should not cause irritation of the eyes.
Avoiding incision complications after eyelid surgery
Most complications involving the eyelid incision happen within the first week. Some of these common complications include incision dehiscence, infection, and scar hypertrophy. A dehiscence is the reopening or splitting of the surgical wound. This can occur if the patient rubs the eyelid or sleeps in such a way that pressure is put on the incision. It may also happen if the patient fails to follow postoperative care instructions such as avoiding lifting heavy objects. If this occurs, you should stay calm and contact your doctor. The surgeon will have to re-stitch the wound under local anesthesia.
Infection of the surgical wound is rare on the eyelid skin but can occur. Eyelid skin has a very rich blood supply which makes it very hard for bacteria to grow in the wound. If the wound becomes infected you will experience pain, swelling and redness. Early detection is important to prevent further complications such as unsightly scars. A short course of oral and topical antibiotics will be enough to treat the infection without mayor sequelae.
Scar hypertrophy is a thickening of the tissue around the incision. This is more common in patients of African and Asian descent and those with a propensity for keloid formation. There is no easy fix for this complication; however, steroid injections can be effective in reducing the size of the scar. Application of ophthalmic anti-inflammatory ointment on the incision early in the postoperative course will decrease the chances of this complication. Use of anti-scaring creams and lotions are to be avoided on the delicate eyelid skin.
To guarantee the best possible outcome after eyelid surgery it is important to have an open line of communication with your surgeon and follow his instructions carefully. The most inconspicuous scar results form a joint effort between the surgeon and the patient.
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