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HEMATOMA after ORBITAL FLOOR RECONSTRUCTIVE SURGERY.

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Hello,my name is Nick,i am not english native so please forgive my broken english.
Long story short,i had a zygomatic-orbital floor reconstructive surgery after an accident i had and traumatized my left side of my face(zygomatic and orbital floor fractured).Now i have metal plates in my face and metal mesh to support my eyeball.
Thing is that now,5 months after the surgery,although i feel zero pain,and almost zero numbness,i got some issues that they really put me down every day.

1.My face looks still swollen,why?After 5 months?(my surgeon said that it is no swollen,but it`s the scar tissue and i should massaje my face to see if it can get more droopy.Will massaje help out?Or i am going to look like this for ever?(pics)

2.My face feels stretched(like something is pulling it up from the inside) and tight all day,every day since i wake up.Why is that?It is so annoying,i can not focus on my job.It`s been 5 months already.Will it ever go away,that feeling?

3.After the surgery i feel my jaw is in a different position.Doctor says that they didn`t touch my jaw,but the way i speak,the way i smile and chew my food,is different now,like i am having a hard time now.Why,what is wrong?Is it the way that my bones healed and my jaw got affected?My (s) now in words sounds like (shhh).What is happening?

4.My lips look like they are pulled up.If you see my pics,on the left side of my mouth,the upperlip is uneven comparing with the right`s side.It`s making a little curve pulled up,and i can see my tooth now on that spot(see pics).Surgeon says that this is another scar tissue as well and i should massaje that spot as well.They said they can go into a stucture releash(releash of the soft tissues) but this is going to leave me more scar tissue and they don`t want to risk it.5 months now did zero improvement though.Is it ever going to come gown on its place again?Or i am going to look like this for ever?(pics)

5.5th and biggest issue of all,is my eye.My lower eyelid is droopy after the surgery(i suppose it`s because of the incision).And my upper eyelid is getting tired easy and gets droopy as well in the day.Plus my new eyeball is more outwards than the right one.I think it`s called exophthalmos,or projection of the eye(see pics).I feel my muscle there is moving slow and lately i got some blurry vision.Surgeon says there is a scar tissue there as well,maybe hematoma,and makes my eye look bulged(pics).Is it going to calm down and gets back into its position again?Or do i need to ask for a follow up surgery?

All these make me feel awful and depressed,plus i think i look like a mosnter.It`s been 5 months now and i know that after the 6th month,thats how my face is going to look like until i die,and i am being scared.

I would appreciate your answers.
Thank you in advance.
Nick.

Category: Cosmetic and Plastic Surgeon

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Category: General Surgeon
 20 Doctors Online

Hello Nick,
Thanks for getting back. Here are the answers to your questions:
1.My face looks still swollen,why?After 5 months?(my surgeon said that it is no swollen,but it`s the scar tissue and i should massaje my face to see if it can get more droopy.Will massaje help out?Or i am going to look like this for ever?(pics)
A: Yes, faces sometimes look swollen when there is an abundance of scar tissue. Postoperative edema of the face persists in some cases for even 6-9 months so you have to be patient. Massaging always helps but you should start this early in the postoperative period so as to encourage the lymphatic flow. There should be a slight decrease in the swelling after a few months.


2.My face feels stretched(like something is pulling it up from the inside) and tight all day,every day since i wake up.Why is that?It is so annoying,i can not focus on my job.It`s been 5 months already.Will it ever go away,that feeling?
A: This is possibly due to the phenomenon of scar contracture. As the scar matures, it tends to contract. Sometimes, you might have to go in for scar revisions to counter this. A scar matures completely in about a year's time so you should be patient during this period.


3.After the surgery i feel my jaw is in a different position.Doctor says that they didn`t touch my jaw,but the way i speak,the way i smile and chew my food,is different now,like i am having a hard time now.Why,what is wrong?Is it the way that my bones healed and my jaw got affected?My (s) now in words sounds like (shhh).What is happening?
A: You need to be evaluated for any involvement of the facial nerve and the muscles of mastication. Sometimes, the maxilla and mandible might not be affected but there might be a disbalance in the facial muscles or the muscles of mastication which can cause this phenomenon. Please get this evaluated.


4.My lips look like they are pulled up.If you see my pics,on the left side of my mouth,the upperlip is uneven comparing with the right`s side.It`s making a little curve pulled up,and i can see my tooth now on that spot(see pics).Surgeon says that this is another scar tissue as well and i should massaje that spot as well.They said they can go into a stucture releash(releash of the soft tissues) but this is going to leave me more scar tissue and they don`t want to risk it.5 months now did zero improvement though.Is it ever going to come gown on its place again?Or i am going to look like this for ever?(pics)
A: As I have mentioned, you should give the scar time to mature which is about a year. You can go in for scar revision only after this period. Till that time keep massaging the areas on a daily basis.


5.5th and biggest issue of all,is my eye.My lower eyelid is droopy after the surgery(i suppose it`s because of the incision).And my upper eyelid is getting tired easy and gets droopy as well in the day.Plus my new eyeball is more outwards than the right one.I think it`s called exophthalmos,or projection of the eye(see pics).I feel my muscle there is moving slow and lately i got some blurry vision.Surgeon says there is a scar tissue there as well,maybe hematoma,and makes my eye look bulged(pics).Is it going to calm down and gets back into its position again?Or do i need to ask for a follow up surgery?
A: If you have exophthalmos then it needs to be confirmed with a Hertel exophthalmometer. If this is confirmed, then you might require a revisional surgery later on.
Regards


Patient replied :

Thanks once again Dr.Souvik,
i don`t want to risk another scar tissue to fix my exophthalmos...if this is a hematoma,is there any chance to settle down by time and get my eye abit inner the eye socket?


Thank you for writing to us again.
Not really, if there is a hematoma, it usually resolves by fibrosis so that you might not get the desired result!
Feel free to discuss further,
Regards


Dr. Souvik Adhikari
Category: General Surgeon
Experience: 
MCh (Plastic & Reconstructive Surgery): Institute of Post Graduate Medical Education & Research, Kolkata.
MS (General Surgery): Medical College, Calcutta
MBBS: Medical College, Calcutta.
Dr. Souvik Adhikari and 4 other Medical Specialists are ready to help you

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