When we set out to make a beautiful eye, we are still working with human tissue and human hands. Sometimes a surgery does not turn out the way we hoped, or the eye settles into a shape that is not quite right.
When that happens, both patient and surgeon find themselves under real stress. The patient wonders, "Did I really pick the right surgeon? Will it go wrong again? I am scared of needles." From the surgeon's side, there is the lingering thought of "if only I had done a little more."
Most plastic surgeons, myself included, consider a revision rate under 10 percent the mark of a strong eyelid surgeon. My own rate is comfortably below 10 percent.
That said, even I revise my own work occasionally. My own sister had a touch-up a week after her surgery last summer for some residual skin redundancy. There are distinct windows for revisional eyelid surgery. 1. Within the first one to four weeks. Most early revisions are ptosis corrections, for over- or under-correction, or when the patient cannot open the eye normally. Patients are often transferred to me from other clinics in this window.
This patient was referred to me by another clinic. I am grateful when colleagues trust me with their patients. 2. Between one and six months. The scar is still maturing and the soft tissue has not settled, so I generally avoid revising in this window. The exceptions are cases where the patient takes on the risk knowingly, or where the result is bad enough that returning to normal social life is not possible. The patient below was transferred to me about a month after her original surgery elsewhere.
3. After six months. This is the most common window for revisional eyelid surgery. The scar has matured enough that we can correct even fine asymmetries.