The need for revision blepharoplasty surgery is becoming more frequent. Patients requiring revision blepharoplasty surgery range greatly in the complexity of the problem from those with minor degrees of scarring to others with severe eyelid malposition affecting the integrity of the eye.
Generally, the eyelid skin heals very well, but occasionally, the healing response that can be move vigorous leading to noticeable scars and bumps around the incision sites. These problems can usually be managed effectively with scar revision procedures.
Sometimes poorly planned surgery or excessive surgery can cause problems. The most severe complications arise from changes in the lower eyelid contour which lead to retraction and exposure of the eye. This can cause severe soreness and dryness as well as devastating aesthetic results.
Revision blepharoplasty is highly specialised and requires a full understanding of what has gone wrong. Relatively minor revisions of scar tissue or excess skin can be performed, but lower lid retraction changes can be much more complex, sometimes requiring several staged procedures. You will have detailed assessment to identify often complex issues underlying the problem.
Eyelid retraction can be due to several factors and usually a retractor release and canthal supspension can be enough to restore eyelid position in mild cases. More severe cases where excess skin and fat have been removed may require building up the different layers of the eyelid using a range of materials such as hard palate grafts to the internal lining of the lid. Where excess skin removal is the problem, every possible avenue to prevent skin grafting is explored, most often involving multiplane midface lifting to recruit more skin into the eyelid area.
Another common complaint following blepharoplasty is hollowing which can affect either the upper or lower eyelids. This is usually due to excessive fat removal, or sometimes atrophy of the fat pads after surgery. Upper and lower eyelid hollowing can be addressed using injectable fillers or fat transfer.