What is the Best Treatment for an Eyelid Burn Victim?

Addressing a burned eyelid has nothing to do with cosmetic surgery which is entirely elective surgery to make our appearance better.  In this case, surgery in function to restore the function and appearance to the eyelid damaged by a burn.  I would recommend seeking care at a University setting from an Oculoplastic surgeon or seeking out a top eyelid specialist for help with this issue.

I would say that you need to see an eyelid specialist. The amount of function and skin that you have in the eyelid needs to be determined from an examination before one of us can intelligiently answer that question. If the muscle in the eyelid is damaged that is difficult to repair and more complex than just putting in flaps of skin. As you probably realize, the eyelid has function. Replacing those muscles are just as important as replacing lost skin so a simple answer of skin grafts DOES NOT apply to all burn victims. See an oculoplastic surgeon.
 

Inability to close the upper eyelid after a burn injury is a result of a lack of flexible eyelid skin. This is treated by scar release and the placement of a thin full-thickness graft from the back of the ears. If this donor site is not available, a thicker split-thickness graft can be harvested from the inner arms or outer thighs. There will always be a color miamatch between the grafts and the rest of the eyelid skin but this is a minor trade-off for a more competent eyelid closure.

Burn victims can have all different types of deformities from burns to the eyes.  Very commonly, the burn scarred skin needs to be removed and grafted or just incised and grafted. Hard to say without an exam.

Hey there,

It's hard to give specific advice or information about your procedure without a photo or more details but as a surgeon who reconstructs eyelids often I can give you a couple of general descriptions.

1.  For any eyelid (upper or lower) with a contracture from burns or injury I've first, released the scar tissue and then placed a skin graft on the outside of the lid to give it more mobility.  If there is injury to the inner lining of your eyelid then you often must also place a mucosal graft.  This can be done by taking a little mucosa from the inside of your mouth.

2.  If it is the lower eyelid I have often needed to do an additional procedure (beyond the skin graft).  This is a lid shortening, or tightening, procedure.  It's pretty standard.  You'd need to do this to help the lower eyelid function properly after the skin graft is placed.  This is really needed for the upper lid.

What can you expect afterwards?

Some dry eye (temporary), some bruising and swelling, minimal risk of infection.  Occasionally lid reconstructions are staged. 

Finally, if you actually have some missing anatomy from your lid a portion of the opposite lid can be used to reconstruct your lid.

You'll do great.  There's some excellent facial plastic and oculoplastic surgeons in Portland.

Best of  luck

Chase Lay, MD