A few years ago I had discoloration on my face and was told to use a steroid cream on my skin to alleviate the problem. For some reason I decided to apply it all over my face, including my eyelids. Today, I am left with very thin, loose skin on my face. My eyelids, especially, are very thin and unnatural in appearance because my eyeballs have sunken deep into the sockets. I also have a lot ofpressure on my eye as a result. Is there any procedure available to bring my eyes forward to their natural position in their respective sockets?
What Can Be Done About Sunken Eyeballs?
Doctor Answers 3
If an orbit has a sunken in look, this may be due to facial wasting or atrophy of the soft tissues. Sometimes facial fillers such as juvederm or even fat injections can help improve this sunken in appearance.
There are procedures to perform this in the case of orbital trauma and uneven height of the globe resulting in double vision but this is generally not performed on an elective basis. Some surgeons perform fat injections to the orbital rim to mask this appearance but it is best done conservatively and on a staged basis.
What can be done about sunken eyeballs?
VERY challenging problem.
With age, as we BOTH lose fat inside our eye sockets (orbits) and face, the eye balls sink in AND the margins of the orbits become more visible. This is the basis for the skeletonized aged look we are used to seeing.
I am enclosing a very touching video of Johnny Cash playing Folsom Prison Blues for the last time in June 2003. His face unfortunately demonstrates this appearance.
Injection of fat / Restylane etc along the surface of the orbit MAY smooth the skeletonized appearance but will NOT correct the sunken eyes. To do so volume needs to be added to the floor and back of the orbit to push the globes out. The only way I know to do it requires an operation we frequently do in facial fractures where the eyeball is moved to the side and wither bone grafts are added to the back or underside of the globe OR the orbit floor is raised with an artificial floor (such as POREX) which is canted on the screw plate (anchored along the orbital rim with 1-2 titanium screws) until the eyeballs are where they should be. Either one of these are NOT small operations and can have significant complications.
I hope this was helpful.
Peter A Aldea, MD, FACS
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