Orbital Blow-Out Fracture Surgery and Enophthalmos (Sunken Eyes)
Listen to Dr. Taban on ESPN LA radio on Orbital Fractures
Orbital Blow-Out Fracture Surgery
An “orbital blow out fracture" results from trauma to the orbit and eye area with resultant force causing fracture of the orbit into the adjacent sinuses as the orbital bones are fragile and thin. The most common location of the fracture is the orbital floor followed by the medial wall. Not all orbital (blow out) fractures need to be surgically fixed. Criteria for orbital “blow out" fracture surgery include large fractures, diplopia (double vision), and enophthalmos (sunken eyes).
Orbital “blow out" fracture repair should be performed within the first 2 weeks of the trauma. Waiting longer can result in scarring and increased difficulty in the repair with lowered success rate. However, at times the surgeon is forced to address the problem later on for various reasons. For instance, sunken eyes from the orbital fracture can manifest or worsen later on. In those cases, surgery is performed later to improve sunken eyes (enophthalmos surgery).
Dr. Taban uses the latest minimally invasive technique to repair orbital fractures and has even penned an article about Orbital Wall Fracture Repair Using Seprafilm.
Video showing orbital metal implant is being removed as it was causing eye motility problem (double vision) and eye pain. It was originally placed by another surgeon to treat orbital fracture. Dr. Taban is against using metal in the orbits.
During your consultation with Dr. Taban in Beverly Hills/Los Angeles or Santa Barbara, he will evaluate your eyes and face and review orbital CT scan to assess the severity of the orbital fracture and need for orbital fracture surgery repair. Dr. Taban performs orbital fracture surgery using hidden incision inside the eyelids, with quick recovery. Orbital blow out fracture surgery is performed under general anesthesia, which usually takes about an hour to complete. As an outpatient procedure, the patient goes home after surgery and follows up in clinic a week later.
Read Article Published by Los Angeles’ Dr. Taban about Orbital Wall Fracture Repair Using Seprafilm
Enophthalmos surgery is done similarly to orbital fracture surgery, requiring an orbital implant. Sometimes, enophthalmos or sunken eyes can be helped with filler injection in the orbit or eyelid, in the office.
Orbital Implant to Treat Sunken Eye from Silent Sinus Syndrome
Young woman with right sunken eye (enophthalmos) due to silent sinus syndrome underwent reconstructive surgery including sinus surgery and right orbital implant placement.
Who Should Treat Orbital and Eyelid Trauma?
The orbit is a small, compact and complex structure. The eyelid is also a mobile, complicated structure, made up of many different layers. Oculoplastic surgeons have undertaken the extra training to deal with the nuances of treating orbital and eyelid diseases and injuries. An oculoplastic surgeon, who is a member of American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), is someone who is a board-certified ophthalmologist who has completed additional 2-year fellowship training in cosmetic and reconstructive plastic surgery of the eyelids, orbits (eye socket), lacrimal system( tearing system) and surrounding structures. Dr. Taban is double board-certified by American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), American Academy of Ophthalmology (AAO), and a diplomat of the American Board of Cosmetic Surgery (ABCS).
Young man, with history of orbital blow out fracture repair using Medpor/Metal Mesh implant (by another surgeon) with recurrent cyst/abscess formation underwent orbital Medpor/Metal Mesh implant removal.
Young woman, with severe eye/facial trauma due to motor vehicle accident, underwent initial left orbital fracture repair with orbital implant and then underwent bilateral lower eyelid retraction surgery plus left infraorbital rim silicone implant.
Before & After Photos
*See disclaimer below
Before (left) 40 year old male, with history of multiple large orbital fractures, with significant enophthalmos (sunken eye) and cheek fracture with sunken cheek. After (right) 4 months after right orbital fracture surgery, enophthalmos (sunken eye) surgery with orbital floor implant, and cheek implant.
Before (left photo) and 3 months after (right photo) of a 40 year old female who underwent right eye sunken eye (enophthalmos) surgery. Note that the right eyeball is lower (termed hypoglobus) in the before photo and then in normal symmetric position in the after photo. She would also benefit from filler injection on both sides.
50 year old female, with history of left eye trauma resulting in orbital fracture with sunken eye and severe left lower eyelid retraction with scarring, underwent left orbital fracture repair with orbital implant, left lower eyelid retraction surgery with skin graft, bilateral blepharoplasty, and eyelid filler injection. Before and 3 months after eyelid surgery photos are shown.
Young man, with severe major right eye trauma, resulting in significant sunken eye and eyelid retraction, who had undergone one previous unsuccessful orbital fracture repair (by another surgeon), underwent revision right orbital implant (removal of old and placement of new implant) plus lower eyelid retraction repair plus upper eyelid filler injection. Note more balanced eye appearance.
Contact TabanMD for a Consultation Today
Dr. Mehryar (Ray) Taban is a board certified ocular-plastic surgeon in Beverly Hills, Los Angeles and Santa Barbara with extensive knowledge in the treatment of orbital fractures and eyelid Trauma. To learn more about the different treatment options that may be suitable for you, contact Dr. Taban today to schedule an initial consultation.
*Disclaimer: Results vary from patient to patient. Results are not guaranteed.