Q: Dr. Eppley, I had cheek and orbital reconstruction on the left side of my face three weeks ago for an old cheekbone fracture. The left area of my face that you worked on is still about 40-50% swollen. I also am still numb in my left lip area and on occasion I feel tingling in my face.
My questions are is the numbness and tingling a normal part of the healing process and if so, how long can I expect that to continue? How long until the swelling goes down completely? Can I take anti inflammatory medicine and use ice packs on my face to help the swelling go down? Will the ice affect the fat injections? Lastly, will the asymmetry of the left side of my face eventually match the right side of my face because as of now, the left side of my face is making it appear that the right side of my face is the side that is flattened?
A: You are recovering exactly as how I would have expected after cheekbone reconstruction (with cheek implant and fat injections). At three weeks after surgery only about 50% of the swelling will be gone. It will take a full three months to see the final result for all swelling to go away. Also I would expect some lip numbness to be present at this point but that will eventually go away with more time. Anti-inflammatory medication and ice packs will not make it go away any faster. This is a process of time for complete healing. I do not judge the result until three to four months after surgery.
Dr. Barry Eppley
Q: Dr. Eppley, about four years ago I emailed you with questions surrounding an injury I sustained to my eye and cheek area some 20 years ago. Again briefly, I was assaulted and never had my cheek and eye fixed. Now I would like to because of the appearance I see in the mirror of a flattened left cheek and slight drop under my left eye. I could not have the procedure done when I first contacted you because of the finances and then the collapse of the economy. But now I am in a position to have the work done and I think and feel you are the best doctor qualified for the job. Can you please provide me again with what would need to be do be done as far as if a CT scan is needed, measurements need to be made and things of that nature. In the light, up close and when I smile, I look fine. But when the lights are dimmed and looking at my face from a distance, the obvious damage and asymmetry is noticed. It is as if I can see the imprint of a fist on my face. I want the left side of my face to be even, full and balanced like my right side. I have included some new pictures. Thank you for your time and please respond and help me if you can.
A: I remember your inquiry and your face problem quite well. You obviously had a cheekbone fracture that resulted in flattening of your cheek bone area as well as along the infraorbital rim. Fortunately your eyeball position looks fairly even with the right side (at least based on the pictures) so no orbital floor or lateral canthal work needs to be done. I think cheek augmentation alone should suffice and the cheek implant needs to be put up high on the flattened cheek bone. Fat injections also need to be done to build up the cheek area where the implant will not reach. We could get a 3D CT scan but that will probably not change your surgical needs unless we decided that a custom made cheek implant would be used for the reconstruction.
Dr. Barry Eppley