Rules for Revisional Eyelid Surgery

A part of my surgical eyelid practice is revisional eyelid surgery. Those cases are patients who have had eyelid surgery such as blepharoplasty, eyelid lifts, ptosis repair with a different surgeon and then seek a redo of the surgery with me in Denver. When one has had eyelid surgery that they are not satisfied with, there is an initial impulse to "fix it immediately". Often healing is all that is needed for the eyelid to go back to normal and time is the only thing needed for things to turn out well. It is important to know that there are several things that set revisional surgery apart from initial eyelid surgery. I can usually fix the eyelid problem when a patient comes to my Denver office but it is good to know some background information on redoing eyelid surgery.

How is revisional eyelid surgery different than the initial surgery?

Revisional or Redo Eyelid Surgery is different than primary eyelid surgery because once an initial surgery is completed, there is scar tissue in the eyelid. Scar tissue is a natural portion of healing but makes further surgery more complicated. The normal anatomical components of the eyelid may not be easily visible during surgery. There may be scar tissue that needs to be excised. The tissue will take slower to heal the second or third time a surgery is completed.

When should I seek to get my eyelids redone if I am not happy with my initial results?

Thought techinically speaking one could come in for a consultation any time after an initial surgery, it best to wait 3 months at a minimum before seeking a consultation after a primary surgery. That gives time for the eyelids to heal after surgery. During the first couple weeks, there is a large amount of swelling and one needs to be patient and wait for the healing to be complete. Contrary to what is seen on TV, there is no “immediate” result that is seen after eyelid surgery. There is often swelling, bruising and the eyelids will lot look initially how they will look when they are healed. If you come early, I most likely will tell you to come back when it is 90 days after surgery. Often when you come back, I would want you to wait some more. A revisional surgery should be done on a stationary target, not on an eyelid that is in the middle of healing.

Can I fly in and get revisional surgery?

I would recommend first getting a consultation. I need to properly asses what is going on with the eyelid and if further testing is needed. Flying in and immediately getting surgery is probably more convenient but not a good method to approach a revisional surgery. You have already been through a lot and this is the time to measure four times and cut once.

What is the expected healing for revisional surgery?

Healing for revisional surgery tends to be longer. With previous surgery, there is more scarring and longer healing. For the eyelids I let patients know that revisional blepharoplasty or eyelid surgery healing normally takes 3 weeks.

What should I bring for my consultation for a redo of my eyelid surgery?

The things I need you to bring are:

Previous photos before your first surgery

Operative Report

Cat Scans or MRIs performed

What can I expect from my eyelid surgery consultation with you in your Denver office?

I can promise to give you an honest realistic expectation of what can be done if I redo your eyelid surgery. The most common revisional eyelid surgery I perform is lower eyelid retraction after blepharoplasty or eyelid lifting. Sometimes the problem can be fixed with a stitch and sometimes there may be skin graft that is needed. The key is to have an honest discussion as to what is needed to fix the problem and if it is worth taking a chance at a more conservative approach (such as a stitch) to fix the problem knowing that an additional surgery is needed. At our consultation, I will discuss all the options with you.

If you need a second opinion after eyelid surgery, call my office in Denver at 303 468 8844 and I would be happy to look at your options.