Can steriods injections eliminate scar tissue formed in lower eyelid and prevent need for blepharoplasty?

It is not uncommon to have some scarring after this sort of trauma.  The scar can pull down on the eyelid causing an ectropion.  Steroid injections, often combined with 5-FU can soften the scar and help to reverse the ectropion.   It is always best to start with low dose steroid as it can cause some atrophy of the normal tissues as well as softening of the scar tissue.  Doing more than one injection is ok if scar bands can still be felt at 2-3 weeks after the first injection.  Wait at least 4-6 months before doing any surgical revision.     

Generally the dry eye is from the compromised eyelid position and dysfunction of the eyelid.  Usually there is also some degree of motor injury that contributes to further dry eye and disfunction.  The steroid injection will soften scaring but it also causes fat atrophy.  Certainly it is reasonable to have the first of these injections but the need for the others should be determined on the basis of how your eyelid responds to the first of these injections.  Ultimately it is not blepharoplasty that is performed to fix this type of issue.  Lateral canthoplasty is also not sufficient to correct these lower eyelid malpositions.  Generally the reduction of the malar fracture is not complete.  This reduces the support of the lower eyelid and cheek soft tissue.  Correction of these issues can require an orbital rim implant, hard palate graft to the lower eyelid, and lateral canthal reconstruction.  Occasional these injuries are even more complex.  If the eyelid does not respond to the steroid injections and it is not likely to, do not accept surgical reconstructions that are unlikely to be definitive such as isolated lateral canthal procedures.  They tend to use up eyelid resources that are needed for definitive repair.  You should allow at least 6 months before having a definitive repair provided you are not having corneal break down.  You also need more aggressive dry eye management and this should be overseen by an ophthalmologist, cornea specialist, or oculoplastic surgeon. 

That is hard to say.  You can certainly try steroid injection and may help.  It all depends on the degree of eyelid retraction/ectropion and scar tissue present. You can wait about 3 months after the trauma before considering surgery.  See an oculoplastic specialist.

Without in person examination I would NOT recommend steroid injections to the lower lids>>>>>>>>>>>>>>>>>>

You should see your ophthalmologist for the ectropion. Generically, steroids are used to treat and soften scar tissue in the body. However, as with any medication there are side effects and risks. A judicious amount injected into the appropriate area of scar tissue in conjunction with massage and other treatments can be helpful.

Dear jasonf_1, Thank you for your question. In order to repair a ZMC (zygomatico-maxillary-complex) fracture the bones of the cheek have to be repositioned and held in place with very small plates and screws. In order to get access to the infraorbital rim, an incision is made either on the outside of the eyelid or on the inside. There is the potential as the incision heals for scar tissue to form. Given that you are a month out from your original surgery you are still very early on in the healing process. I would recommend massaging the lower eyelid frequently throughout the day and using moisturizing eye drops to prevent corneal dryness. I personally have not had much success with steroid injections in the lower eyelid for ectropion but I do not see any major downside to using them. I would wait around 3-4 months to see if the scar tissue releases and the ectropion improves before considering surgery. Best of luck, Dr. Schoemann

At this point, I would recommend gentle massages to the area. Kenalog can help however depending on the severity of your scar tissues. Conservatively, massage your lower eyelid in a middle to outward direction. This can help facilitate proper healing. See your local plastic surgeon for suggestions on kenalog. Hope this helps! Dr. Miguel

The dynamics you are describing around the lower eyelid are very complex. It is imperative that you see and get examined by a qualified surgeon to deal correctly with this matter. It is impossible to assess the pathology simply from a photo and the fact that you already have dry eye problems means the issue must be dealt with. Kenalog is good to help with certain scar concerns but MUST be used judiciously and correctly. Improperly used it can lead to fat loss, skin thinning , and potentially make your ectropion worse by weaking the tarsal structures. Not all plastic surgeons and ophthalmologists handle these problems so see someone with "complex" lower eyelid problem experience only .....otherwise you might make things worse.