NON-SURGICAL COSMETIC OPTIONS
TRAUMA (ORBITAL FRACTURES, EYELID LACERATIONS)
Trauma to the eyelids and/or orbit (eye socket) should be examined thoroughly by an ophthalmologist and oculofacial plastic surgeon. The eye is often involved in this type of facial trauma so a careful eye examination should be performed without delay.
Trauma to the eyelids may result in lacerations (cuts to the skin) that may involve the entire thickness of the eyelid margin (where the lashes are located), and/or the tear duct system. Inadequate surgical intervention for these types of injuries may result in eyelid deformity, incomplete eyelid closure, or tearing problems. Oculofacial plastic surgeons have had extensive training to treat these injuries and ensure proper healing. Eyelid lacerations may often be surgically reconstructed in the office under local anesthesia. More complex eyelid trauma, especially when involving the tear duct system, may require reconstruction in the operating room under sedation.
Blunt trauma to the eye from an assault, a fall, or a sports related injury may result in a fracture of the eye socket, also known as an orbital fracture. The most common type is a fracture of the floor or medial wall (the wall located between the eye and the nose) known as a "blow-out" fracture. A blow-out fracture results in sinking of the orbital contents through the bony defect, which can cause the eye to sink back into the orbit, a condition called enophthalmos. Orbital fracture repair is performed to prevent the eye from sinking back into the orbit. If enophthalmos is already present, surgical fracture repair and orbital reconstruction may be performed to move the eye back into a normal position.
The decision to perform a fracture repair surgery depends on the appearance of the fracture in a CT scan, and the clinical examination. A fracture repair surgery generally involves making an incision behind the eyelid (this spares the skin so that there is no scarring). Once the fracture is located, a piece of titanium mesh (sometimes combined with a biocompatable material called Medpor) is placed over it to cover the defect. The surgery is performed under general anesthesia, and patients may expect to stay for 1 night in the hospital for observation.