Rochester Doctors

Broken Orbital Bone and is Sinking, What Should I Do? (photo)

I got punched in the face a lot when I had a drinking problem (sober now) but I'm afraid my eyeball is sinking. I know for sure I broke the orbital floor of my eye at least once (the second time I was in mexico two years and couldn't get a professional opinion). I'd like to know if my eye will keep sinking. Please see the photo and let me know if you think this problem can be fixed. Thank you.

If you had a trauma that caused a fracture of the bones around the eye, it is possible that the eye is sinking backward.  In most cases this can be improved with surgery. The first step is to see a surgeon who has experience with orbital trauma such as an oculoplastic surgeon.  Your doctor will want to get a CT to see what is happening with the bones around the eye.  Surgery can be more difficult when the problem has been there for a while but it is still possible most of the time.  

Good luck!

Brett S. Kotlus, MD

Rochester Oculoplastic Surgeon

Fat injections under eyes do not work so far...

I had a transconjectival upper and lower blepharoplasthy three years ago. This left a lot of loose skin and hollowness under my eyes, and uneven upper eyelids. So : I had (6 months ago) bilateral lower skin pinch (the left side has very bad scar even 6 months later) and upper left additional blepharoplasthy to make the upper eyelids even on both sides; I also had at the same time upper and lower fat injections (3cc each) on both eyes. Now the upper eyelids do look just a little better than before, but the lower right is still hollow – 6 months today after the fat injections. The surgeon tells me to wait a year, that the fat will grow its blood vessels and it will fill the hollow part. I am very skeptical about that.. Any input will be appreciated…

Fat transfer has the potential to significantly improve lower eyelid hollows, particularly when fat is injected deeply along the bony infraorbital rim and along the cheek to create a smooth transition between the two areas. You can usually determine how much fat has survived at the 6 month mark. It is not likely that more fat will appear over time.  I would consider another session of fat transfer or an injectable hyaluronic filler to the area, but of course you should consult with a surgeon that is experienced in facial fat transfer.  

Brett S. Kotlus, MD

Rochester Oculoplastic Surgeon

Will Hot Compresses Breakdown Fatty Tissue Under Eyelids?

My Dr tells me I have excess fatty tissue under my eyelids. He said to use hot compresses to breakdown this fatty tissue. Everything I have read in my research says the only way to deal with this is surgery. He never mentioned surgery. I don't know what to do and could use some more information.

Many people believe that warm compresses can reduce swelling or edema (fluid) under the eyes.  It will not influence the fat under the eyes.  The best way to address lower eyelid fat pouches is with surgical blepharoplasty or in some cases they can be disguised with injectable fillers. A consultation with a cosmetic surgeon that specializes in eyelid procedures, such as an oculoplastic surgeon will be of benefit. Good luck! 

Brett S. Kotlus, MD

Rochester Oculoplastic Surgeon