Three Months After Orbital Blowout. Lower Lid Dropping? (photo)

Medpore placed under my eye. Healing was going ok but now seems to have taken a turn for the worse and the lower lid is dropping. Two weeks ago i was able to pull the lid up and it would stay however now it seems to have actually started moving downwards. Also if i pull it up drops back in to the position. Particularly if I am tired.. Any suggestions? Also it does not move the same. I have to really make an effort to get that lid to move.

Doctor Answers 10

Problem after orbital fracture surgery

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It is difficult to tell from your photo. There could be a variety of reasons.  Discuss with your surgeon or see an oculoplastic surgeon.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Eyelid malposition after orbital floor fracture repair

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Dear Rotato Poti

Sorry to hear about the fracture.

  • if the surgeon used an inside the eyelid incision (as it appears they did), then scarring may pull the eyelid down and tether it to the bone
  • This may improve with massage and time
  • a grafting procedure from inside the mouth is possible, but I would continue gentle massage and discuss with surgeon
  • Best Wishes

Travis T. Tollefson, MD, MPH
Sacramento Facial Plastic Surgeon

Three Months After Orbital Blowout. Lower Lid Dropping? (photo)

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It sounds like scarring may be occurring, pulling your eyelid down.  You should see your surgeon and possibly an Oculoplastic surgeon for treatment.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

Eye lid

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See you surgeon and discuss which approach they used. All approached may have scarring that causes the lid to retract. Sometimes massage and steroid and maybe taping can help

Lower Lid Dropping after Treatment of Orbital Blowout Fracture

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It is difficult to tell the approach that was used to treat your fracture from the photos (either through the skin under the lash line or on the inside of the lid).  With either approach there may be some lower eyelid retraction from scarring.  I would review the problem with your surgeon.  I frequently have the patient mobilize the lower eyelid superiorly to try to stretch out the scar tissue.

Michael Sundine, MD
Orange County Plastic Surgeon

Orbital floor fx and medpor

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With orbital floor fractures, medpor is a good product to use to cover the floor defect. Based upon the approach used, one might develop scar tissue that affects the lower lid. Best to be seen in person by your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Lower lid changes postop

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Hello Rotato Poti-

You mentioned that you suffered an orbital floor blow-out fracture three months ago (I assume  that you did not also fracture your orbital rim). This trauma and the healing after its repair with Medpore causes a lot of scar (collagen) to form, which is good because it seals everything together. As with many things in life, scar also has a downside as it tends to contract with time. If more contraction occurs than is desired, it can pull on surrounding structures like your lower eyelid. Counteracting this scar pull with massaging of your lower lid in the upward direction is very helpful and can often prevent the need of any further surgery. Time also helps soften scar, so be patient and massage lid if your surgeon concurs with this approach.

Good luck to you.


Mark Anton, MD, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 38 reviews

Lower Lid Retraction after Orbital Fracture

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Both the trauma that caused the Orbital Fracture and the surgery needed to correct the fracture can result in the lower eyelid being pulled down. It is usually due to scar tissue contracting in the post-operative period. If conservative treatment does not resolve the problem, then a surgical repair to release the scar tissue and re-support the eyelid is necessary. This can be a complex and tricky operation and should be performed by an Oculoplastic Surgeon that is experienced with this problem.

David Schlessinger, MD
Long Island Oculoplastic Surgeon
4.8 out of 5 stars 18 reviews

The situation and answers are often complex.

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The orbital repairs can have an impact on lower eyelid support.  This very much depends on the precise surgical approach taken to enter the orbit when placing the medpore floor implant.  Supporting a falling lower eyelid can be a big undertaking.  Anyone who tells you that you just need a stitch in the lower eyelid is oversimplifying what is needed.  However, without a personal assessment, it is not possible to tell you what you need.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Lower eyelid scarring after orbital surgery

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Lower eyelid changes can occur after orbital surgery. The incision to get to the orbit was likely made through the inside of your eyelid, which can affect some of the tissues, causing them to loosen or scar.  You should see your surgeon or an oculoplastic surgeon about correcting this problem. They can often tighten up the eyelid and/or put in a spacer to help keep it in a normal position.

Matheson A. Harris, MD
Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

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.