Is there a way to fix this "stiff bottom eyelid"? (Photo)

ATV accident broke nose and orbital floor. Had a plate put in Oct 2015, had that plate removed and new 1 placed slightly towards the inside wall in jan 2016. had 3 more surgeries to try to fix this stiff eyelid and correct the "wing" corner of my eye. (2 different doctors) nothing has helped. tear duct is has also curled in. Can someone please explain to me what is happening, is this fixable, should i get another opinion, or wait till after i get my nose fixed (in 2 weeks) before proceeding???

Doctor Answers 1

Stiff lower lid after ATV

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You have been through a lot of surgery since your accident... It might be a good time to give those tissues a rest while you have your nose repaired. After you have healed from the nose, you could seek another opinion regarding the eyelid. Often when the orbital bones are fractured, repair involves entry through the lower lid either from the skin side or behind the lid. The plates used to cover the fracture site may be secured to the orbital rim. During the closure of the entry incision or after healing, the layers of the lid may scar and pull downward. Another structure, the lid retractors may get caught up in the repair site as well. It appears from your photograph that you had a vertical laceration through the margin of the lid... a lot of trauma! To answer your question - the lid problems may be repaired after the inflammation from previous surgery has settled. Six months from your previous surgery is a reasonable time frame. Improvements may be expected in the lid margin (better alignment of the margin where the laceration was located), elevation of the lateral canthus which appears to be pulled down, and release of the scar tissue tethering the lid to the bone. Take your time with your decisions and be sure to seek out an oculoplastic surgeon with experience in trauma to help you with these revisions. You have been through quite a lot. Ideally, this would be the last procedure on your lower lid! Best wishes with your upcoming nose surgery!

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