American Society of Plastic Surgeons
For Medical Professionals
Manny Cambra
2 years ago

Cortisone to fix lower eyelid malposition caused by scar; ectropion

7 years ago I suffered an orbital blowout fracture to my right eye socket. The surgery to repair the orbital bones required an incision below/along my lower eyelid.

My lower eyelid does not cover my eyeball the same way as my left side and it’s noticeable in pictures.

Could a 5-FU/kenalog injection eliminate the tension and pull that the scar has on my eyelid? If not, what would you recommend?

Procedure: Eyelid Surgery
Location: bethel, CT

Replies 6

Steven Wallach
ASPS Surgeon

A Cortisone injection at this point would not be very helpful. You likely are scarred down and need release of the soft tissue and possibly support to the lateral lid to improve the ectropion that you now are experiencing.

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Rahul Vemula
ASPS Surgeon

Thanks for your question. You have a condition called sclera show ( the white of the eye being more visible ) you may also have a condition called ectropion where the eyelid turns outward. You will need a revision surgery as a steroid injection won’t help in this situation.

Rahul Vemula, MD - Plastic Surgery of the Face and Body

Diplomate of The American Board of Plastic Surgery

Diplomate of The American Board of Surgery

Active Member, ASPS

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Felipe Gonzalez Parada
ASPS Int. Surgeon

Hello . Unfortunately a 5FU/Kenalog injection, will not be useful, and could worse the skin condition. Definitely you need revision surgery.

Nelson Castillo

Thank you for sharing your question. After seven years a cortisone injection or 5-FU would not likely help to release the scar tissue causing the scleral show created by the ectropion and most likely a surgical revision would be a better option for you.

Susan Buenaventura
ASPS Surgeon
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It sounds like you have "sclera show", meaning the white part of the eyeball is exposed. At 7 months out, it would be appropriate to return to surgery. If you are older, your lid muscles may have had some pre existing laxity which can be corrected with a canthopexy or tightening of lid. The scar of the lower lid will likely need to be released and if skin is too tight a graft may be needed. Your surgeon can help determine what is needed.

Jon Ver Halen
ASPS Surgeon

Hello and thank you for your excellent question. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. Options include steroid injection, scar release, or grafting to the inner surface of the eyelid to release the scar. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!


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