A patient who returned recently — a two-line revision (crease-thinning that preserves the existing scar) performed about two years ago.
Pre-op, her crease had been set quite high.
Even though it was high, the line had partly released, and scarring was making the line look uneven.
Because her crease was set so high, simply excising the scar would have left her short on skin and made the shape worse.
The plan was to find as much healthy tissue as possible, set the new crease there, and release the existing scar to prevent re-adhesion. Those are the keys.
On top of that, we protected the orbicularis oculi to avoid lagophthalmos and minimized any additional scar burden.
Two years post-op.
Recently we added a lateral canthoplasty and lower canthoplasty.
The shape is good. The upper arrow points to the original scar (a faint line); the lower arrow points to the newly formed crease.
All photos above are real patient images, no Photoshop — cropped only with Alcapture.
Video attached as well.