I suffered an orbital floor fracture which has made my eyes asymmetrical. My right eye has drooped down and back slightly. I know the results won't be perfect symmetry since my right eye is displaced a few millimeters, but does anyone know if the double eyelid procedure can be used as an alternative to orbital floor fracture repair to restore some of the symmetry in the eyes. Also, is there a large discrepancy in cost between double eyelid surgery and orbital floor fracture repair?
Is There A Large Discrepancy In Cost Between Double Eyelid Surgery And Orbital Floor Fracture Repair? (photo)
Doctor Answers 5
Eyelid surgery vs orbital surgery
Although eyelid surgery can be done to camouflage the asymmetry you are describing, it is best, if possible, to address the true underlying problem. Orbital surgery, in general, is more extensive, requiring general anesthesia, and costing more. See an oculoplastic surgeon for evaluation.
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First, so sorry for you injury.
An orbital floor fracture repair is a major undertaking that requires general anesthesia and many hours of surgical time and the placement of a titanium, porous polyethylene, or combination titanium and porous polyethylene floor and wall implant. A CT scan is also a necessity for diagnostic purposes. While this is out patient surgery, it is truly expensive undertaking. For many, health insurance helps with the financial burden. For you double fold surgery will not be an alternative. Double fold surgery will reveal more of your eye shape and expose that your right eye is clinically enophthalmic (i.e. the right eye sits more than 2 mm back compared to the left eye). RIght now the heavy eyelids actually hide this fact. Getting double fold surgery will not mask the issue with the right eye but rather make it much more obvious.
Orbital floor fracture and cosmetic eyelid surgery
Double eyelid surgery has about as much to do with an orbital floor fracture as hand surgery. Your attempt to compare costs between the two in deciding on treatment is disturbing because a significant orbital floor fracture should be repaired as soon as the swelling has resolved enough to allow the surgery. If you wait too long some of the changes due to the fracture become irreversible. Your posted photo shows classical signs of a right orbital fracture with the eyeball sinking back and down as the fat that normally cushions it in the socket falls through the fracture site. The swelling is gone so you may already be to some degree past a point of no return.
Functional surgery should always be a priority over cosmetic surgery but that does not mean that one precludes the other.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.
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Is There A Large Discrepancy In Cost Between Double Eyelid Surgery And Orbital Floor Fracture Repair?
The answer is a definite, No. Double eyelid surgery can be highly effective to create or accentuate the eyelid crease. However, your issues with an unrepaired orbital blowout will result from the eye falling or drifting further back into the eye socket due to the fracture. This is assuming that your eye is moving normally and there is no restriction in movement of your eye muscles. The shifting of your injured eye can also cause double vision. None of these orbital issues will be remedied by double eyelid procedure. The safest way to proceed would be to have your orbital fracture evaluated and repaired, if indicated. After you've healed several months you can discuss double eyelid surgery.
With regard to cost, an orbital fracture repair should be covered by your health insurance whereas a cosmetic eyelid procedure would be an out of pocket expense. I hope this information is helpful.
Stephen Weber MD, FACS
Double Eyelid vs Orbital Floor Fracture Repair
When talking about double eyelid surgery vs orbital floor fracture, we are talking about two very different parts of the eye. A double eyelid procedure is not generally considered to be an alternative to repairing the orbital floor.
If there has been trauma causing the orbital floor fracture, it is recommended that it be repaired as there can be significant sequelae in the future (depending on how big the fracture is). There is a cost discrepancy in that the orbital floor usually needs to be repaired using titanium plates. Please consult with a board certified specialist who can assist you in achieving the results you seek. If you have any imaging (e.g. CT scan) please bring them to your consultation.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.