Eye Shape Change After Car Accident, Scarring Around and in Eye Lid, What Revision Can Be Done?

3 and half months ago I asked a question regarding my scar that was wrapped around my eye after hitting the steering wheel of my car. The doctors said there was a cheek bone fracture, but it was relatively clean, and that I had a possible orbital blowout. The lower and upper eyelid appear to have changed and it looks like I have a smaller eye, also the upper eyelid scar is effectively acting as the crease/fold in my eye lid. It looks like ptosis, but I thought that was just upper lids...

Doctor Answers 5

These photos are not very good.


Sorry to be picky but the angles on these photos actually make it more difficult to assess what is going on.  A straight ahead photo showing both eyes and a full face picture would be very helpful.  When you call yourself EnglishBill does that mean that you are in the UK?  In the United States you would have had a CT scan of the orbit to look for an orbit fracture so there would be no question of what you do or do not have.  While it is true that may orbit and even some cheek fractures don't need to be repaired, with the CT scan one knows immediately what is likely going to need and early repair and what can be observed.  From these photos it is not clear but it does not look like the right eye has sunken all that much.  On the other had, you are definitely missing volume at the top of the cheek and I agree that the scars are nasty.

At this point, I think it is still worth seeing an oculplastic surgeon especially if you have health insurance and live in the United States rather than the UK where care effectively is rationed (please don't hate me for saying that).  The scars may need to be revised.  At 3 and a half months after the accident, it is probably best if you wait at least another 3 to 6 months before consider having these scars revised.  Assuming that you do not need the orbital floor repaired and that can only be determined with the benefit of a CT scan and an in person examination, the hollow at the top of the right cheek could be helped with Restylane filler.

You best bet for improving this situation is seeing the right specialist and yes, there is help out there.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Eye Shape Change After Car Accident, Scarring Around and in Eye Lid, What Revision Can Be Done?

It appears that the scar tissue is tethering some of the surrounding skin and limiting the motion too. I think possibly some steroid injections into the scar tissue to attempt to soften it at this point can be done. I think seeing with X-Rays if you do have an orbital blow out is a good idea. If there is, it might need to be repaired in order to properly suspend your eye in the socket. Down the road in a few months some scar revisions might be in order surgically if things do not get better.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

CT scan is imperative

Unless we have improve photo angles to see true asymmetry, it will be impossible for us to give you an accurate recommendation. You definitely will need a CT scan to assess the underlying bony anatomy if there is a significant asymmetry.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

Eye Shape Change After Car Accident, Scarring Around and in Eye Lid, What Revision Can Be Done?

Without a good personal examination, it is hard to tell you what needs to be done.  I can tell you that revision can be done and that you should see an Oculoplastic surgeon to find out what would be best for you. 

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon
4.7 out of 5 stars 16 reviews

Eyelid Scar Contracture And The Timing Of Scar REvision

Your photos are not ideal and your facial fracture history is not clear. But what is apparent is that you have a scar encircling the outer aspect of the upper and lower eyelids. This pattern of scar and its location has caused contracture around the eyelids and a bit of a trapdoor deformity between the lower eyelid and the cheek. This is probably why you feel the eyelids are smaller. This is expected given the location of scar and the time of three to six months after surgery when scar formation and healing is most active. This may ultimately benefit by scar revision but that should await a minimum of six months to one year after the injury until the scar tissue and eyelids feels more soft.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 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.