As part of the trauma of the upper third of the massive face, the fronto-orbito-zygomatic arch is the most frequent and is often associated with eyelid involvement. From 2001 to 2008, 135 patients with fronto-orbital eyelid complex alterations occurred at our center; the patients were included in clinical follow-ups until 2010. Most patients (80%) came to our observation in a state of emergency due to automobile accidents, sports injuries, or assaults, whereas a smaller proportion (20%) was because of previous trauma or surgery. Among the urgent patients, 28 patients present bone lesions without soft-tissue involvement, 62 present bone lesions with soft-tissue involvement, and 16 present only soft-tissue lesions. Among the patients who came as outcomes, in 16 patients, a bone review was necessary; in 15 patients, only soft-tissue review was necessary; and 8 patients needed only scar outcome review. Soft-tissue treatment was more difficult, especially the eyelid. The eyelid must be treated as soon as possible to avoid corneal lesions and major complications like total vision lost. The surgical design must satisfy even the aesthetic profile to guarantee functional success and aesthetic too.