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Topic 28 - 8
Revision Blepharoplasty:
hollowness after blepharoplasty Risks & Revision upper blepharoplasty revision surgery

"The greatest enemy of "good" is "better".
The ultimate enemy of "good" is "perfect."
-- Gay

The results of some cosmetic surgery procedures can be either reversed or readily enhanced to look better if a patient is unhappy with the outcome. Breast implants can be removed or replaced. Overdone noses can often be reshaped. Flaps on some asymmetric face lifts can be opened and redraped.

On the other hand, unsatisfactory results following other types of cosmetic operations are much more difficult to revise. The delicate tissues of the eyelid are notoriously unforgiving in their response to overzealous surgery and even more unforgiving to attempts to undo the damage.

eyelid recontruction

Bad blepharoplasty is not easy to reverse (eyelid surgery complication photos). Not only is the eyelid's anatomy complex but the underlying mechanisms that control its movements are amazingly intricate and seldom able to be fully restored once damaged.

Any patient with a disappointing result should return to the original surgeon to discuss the problem and any possible solutions. While many flaws may resolve or be blunted with time (3-6 months or more), more resistant difficulties may sometimes require further surgery.

Seeking additional surgery to "perfect" an already acceptable result, however, is seldom wise and may result in unexpected outcomes. Unrealistic expectations are seldom remedied by revisional surgery.

Although most overcorrections can be at least partially improved by techniques incorporating surface rearrangement and/or deep reinforcement, severe tissue shortage or scarring may require extensive reconstructive surgery.

Especially in patients who have already undergone multiple operations, some overcorrections cannot be helped using currently available techniques.

Undercorrections (insufficient tissue removal) are generally more amenable to improvement, although the solution may entail redoing the blepharoplasty in full, restarting the healing process from scratch, and, of course, again facing a risk of overcorrection.

Not only is revision blepharoplasty much more difficult to perform, but the outcome is less predictable, healing may be prolonged, improvement is usually only partial, and multiple operations are not uncommon. In the words of one sage surgeon:

"There is no complication so terrible that it can't be made worse."

Next: Treatment of Upper
Blepharoplasty Complications

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