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

Question

I had a ZMC fracture repaired on November 24th. At the time of this post it is December 29th. Scar tissue has formed inside my left lower eyelid causing the eyelid to retract slightly (ectropion). My left eye is now dry and unsymmetrical compared to my right eye. Is an injection of Kenalog-40... approximately 10mg every 3-4 weeks for three injections appropriate? I am concerned the steriods are too risky to the integrity of my eyelid, however, I want to prevent the need for blepharoplasty.

John J. Martin, Jr., MD · Answer

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.

Kenneth D. Steinsapir, MD · Answer

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.

Mehryar (Ray) Taban, MD, FACS · Answer

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.

Darryl J. Blinski, MD · Answer

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

Richard O. Gregory, MD · Answer

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.

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

Answers (8)

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

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

Answer: Eyelid steroid inections for ectropion

Answer: Eyelid steroid inections for ectropion

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

Answers (8)

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

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

Answer: Eyelid steroid inections for ectropion

Answer: Eyelid steroid inections for ectropion

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Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.