Reconstructive Surgery
 

Trauma and Maxillofacial Surgery

 Trauma can affect any structure of the eyelid, eyeball and the surrounding bones (fracture) depending upon the mechanism and force of injury. Laceration of the eyelid needs meticulous placement of stitches to preserve its normal shape and function. Injury to the tear ducts (canaliculus) within the eyelids require special placement of silicone tubes within them to keep them open while the injured eyelid heals. A thorough examination is also done to find out if the eyeball is also injured.

Fractures of the bone surrounding the eye (orbital walls) may cause the eye to sink back into its socket, lead to a facial deformity, poor eye movement, or loss of vision. A clinical examination combined with a CT scan of the orbit can easily detect any of this possibility. The presence of any retained foreign bodies also needs to be ruled out. Orbital fractures can now be repaired with minimal incisions through the inside of the eyelid or mouth. Most often, a barrier has to be placed to cover the fracture site. Excellent synthetic plates (polyethylene or silastic) are available for this purpose, or alternatively a small sliver of patient’s own bone can be safely removed from elsewhere and placed over the fracture site. 



Right orbital floor fracture with muscle entrapment, treated with emergency surgical correction 
through hidden incision behind the lower eyelid.



CT scan images of the same patient before (top images) and after (bottom images) the fracture 
repair with porous polyethylene sheet.



Severe avulsion injury of both eyelids treated with staged cosmetic corrections. Tear duct was also
damaged, which was repaired by an innovative technique to avoid constant watering in future. 
(Read more about related medical literature published by Dr Naik)



Severe fracture of cheek bone (zygoma) and orbital floor treated with plate and screw fixation as well
as orbital plating.



Right lower eyelid and tear duct injury treated with meticulous suturing to achieve near norma lcosmetic results.



Hypertrophic ugly scars of injury or surgery can be modified and improved with special antifibrotic injections and laser scar therapy.

Surgical Time and Recovery:
Eyelid laceration repair can be performed under local or general anesthesia, depending upon the location and extent of the injury. Fracture repair almost always requires general anesthesia. Trauma repair can take anything from 30 minutes to 3 hours. 
Discomfort is controlled with medications after surgery, and lasts for a week. Stitches are removed in 5-7 days. Most patients are back to light work within a week.

Caution:
The outcome of trauma repair entirely depends upon extent and severity of injury. Healing often continues for months, and treatment has to be modified according to the course of healing.

Insurance:
Health insurance will cover the costs of trauma repair.

Other Procedures:
Other commonly performed reconstructive procedures include correction of Eyelid Lift (Blepharoplasty), Entropion, Ectropion, Eyelid Drooping, Eyelid and Skin cancer reconstruction, Facial Spasms, Facial Paralysis, Watering Eyes, Thyroid Eye Disease, and Orbital Surgery.