Blepharoplasty Scars: Where They Sit, How They Hide, and How They Fade

Blepharoplasty scars are deliberately hidden: the upper-lid incision sits in the natural crease of the lid, where the fold conceals it once the eyes are open; a transcutaneous lower-lid incision runs just below the lashes; and a transconjunctival lower-lid incision is made inside the lid, leaving no external scar at all. The fine lines redden and feel slightly firm at first, then flatten and fade over weeks to a few months, with scar maturation continuing up to around 6 months¹.

Scars were the thing I quietly dreaded most, because it was my face and there is nowhere to hide an eye. What surprised me afterwards was how little there was to find: a faint line in each upper crease that I had to hunt for in the mirror, and nothing at all where my lower lids had been done from the inside. This is the plain account of where the marks sit, how they hide, and how long they take to disappear into the fold. For the whole operation they belong to, start with the pillar on blepharoplasty.

Where do the scars sit?

Where the scar sits depends entirely on which lid and which technique: the upper-lid line runs along the natural crease, a transcutaneous lower line runs just beneath the lash margin, and a transconjunctival lower incision hides inside the lid with no external mark. Each is chosen so the healed line falls where the eye’s own anatomy conceals it².

That placement is not an accident; it is most of the craft. An upper crease is a natural fold that closes over the line every time you open your eyes, and the lash margin casts the lower line into shadow. The upper blepharoplasty incision and the different lower approaches each carry their own scar story, which is why “will it scar” has no single answer until you know which operation you are having.

How the upper-lid scar hides in the crease

The upper-lid scar is placed in the supratarsal crease, the fold where the lid naturally creases when you look up, so when your eyes are open the fold rolls over the line and it is very difficult to see. The non-dissolvable stitches usually come out at 5 to 7 days, leaving a fine pink line that pales over the following weeks³.

For the first fortnight mine were a definite pink, a little tender, and easy to spot if you looked; by six weeks I had to actively search for them. Eyelid skin is some of the thinnest on the body and tends to heal into a discreet line, which is part of why upper blepharoplasty scars have such a good reputation. At the outer end the crease sometimes extends a fraction into a laughter line, and even that settles into the existing creasing of the eye.

The lower-lid scar, and the scarless option

A transcutaneous (external) lower blepharoplasty leaves a fine line just below the lashes, which fades over weeks to a few months; a transconjunctival lower blepharoplasty is done through the inside of the lid and leaves no external scar at all, though it treats fat rather than removing loose skin. The route is chosen for the lid in front of the surgeon, not for the scar alone².

This is the one place where “scarless” is a genuine and honest description of the skin, and it is set out fully in transconjunctival blepharoplasty. The trade-off is real: the inside route reaches the fat pads beautifully but cannot take away a curtain of crepey skin, so where skin is the main problem an external line under the lashes, or a small skin pinch, may be the price of the result. When mine were done from the inside there was nothing on the skin to nurse, which felt strange when the puffiness had gone.

How long the scars take to settle

Fresh eyelid scars are typically pink and slightly firm, soften and flatten over the following weeks, and continue to pale and mature for up to around 6 months before they reach their final, quiet state. The most conspicuous phase is early and brief, and the scars keep improving long after you have stopped thinking about the surgery¹.

The honest thing no one quite told me is how much changes between week one and month three. An early line can look pinker, firmer and higher than the one you keep, and a crease that seems a touch hard at two weeks softens as the swelling underneath it goes. The eyes you see early are still settling in every way, which is laid out day by day in eyelid surgery recovery week by week. Judging a scar at a fortnight is judging it far too soon.

Looking after the scar

Eyelid scar care is mostly gentle and undramatic: keep the healing line clean, protect it from strong sun while it is fresh, avoid picking at crusts or the small milia that can form, and follow whatever wound-care, massage or silicone routine your own surgeon sets. Timing matters, so any product goes on only once the wound has fully closed and only if your surgeon advises it⁴.

The one I was warned about was the sun: a fresh scar can darken if it catches strong light, so a hat and shade in the early weeks are worth the bother. The little white bumps that appeared along one incision turned out to be milia, tiny keratin cysts that are common as the skin heals and usually settle or are easily removed. None of this is heavy work; eyelid skin does most of the healing on its own, and the job is mainly not to interfere with it.

When a scar is not settling

Most eyelid scars fade so well that nothing needs doing, but a scar that stays thickened, red or raised past the early weeks, a visible or asymmetric line, or persistent milia are the uncommon reasons a surgeon may review or revise it, usually only after the scar has fully matured. Visible scarring is one of the recognised, if infrequent, complications of the operation¹.

If a line is genuinely not settling, that is a follow-up conversation, not a private worry, and revision is generally held back until maturation is complete, which can take up to around 6 months or longer. Where a scar is a symptom of something more, such as a lower lid that is being pulled down, the issue is the lid position rather than the scar itself. The fuller picture of what can go wrong near the eye, and how uncommon each is, sits in blepharoplasty risks and complications.