What Can Help a Droopy Eye Caused by a Traumatic Scar Under the Eye Pulling It Down?

Question

My girlfriend was in a car accident and now has a scar from her forehead to her mouth. She has had some plastic surgery, but the doctors told her to have realistic expectations. Her mouth is still crooked, her cheek is looking better and there is a scar on her forehead. She is most concerned about the scar under her eye tugging it down and making it droopy. What kind of plastic surgery can be done to help correct that?

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

John M. Hilinski, MD · Answer

Sorry to hear about your girlfriend's situation. I don't know how far out from the injury she is currently, but in some situations a steroid injection can help soften a scar that is causing a pulling sensation. In many patients it actually takes a series of steroid injections to achieve the desired goal. When this doesn't work or is not a viable option, some plastic surgeons will then consider lower blepharoplasty surgery to help reposition the eyelid. This might involve incisions made in and/or around the lower eyelid to counteract the unwanted downward force of the scar. Make sure you consult with a facial plastic surgery or eyelid specialist who has experience in managing injuries like this. Best of luck.

Carlo Rob Bernardino, MD · Answer

The lower eyelid is particularly susceptible to malposition from scars. The contraction of scars pull an lower eyelid downward causing ocular drying and can lead to vision loss. Eyelid reconstruction often requires excision of scar and reconstruction with skin grafts or flaps. The importance is to have a surgeon experienced in working around the eyes such as an oculoplastics surgeon.

Steven Wallach, MD · Answer

It sounds like your girlfriend has scleral show. Sometimes the scar pulls on the lower eyelid and this may need a scar revision or even a graft.

Stephen Weber MD, FACS · Answer

Impossible to say for sure without a consultation but a cheek scar pulling down the eyelid can often be repaired by scar revision with Z-plasty. This technique helps to not only revise and reorient the scar (improve appearance) but also to lengthen the portion that is pulling down the eyelid (release the lid). With the limited information provided, this will likely be the best option.Stephen Weber MD, FACS

Darryl J. Blinski, MD · Answer

Sorry for her problems. Multiple scar revisions can be done over the course of a few years. Since no photos were posted hard to give exact answer. Best of Luck.

What Can Help a Droopy Eye Caused by a Traumatic Scar Under the Eye Pulling It Down?

Answers (6)

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