Is horizontal eyelid (palpebral fissure) elongation possible on the Caucasian patient, through orbital surgery? (photos)

Question

Another concern I have about my eyelids is their horizontally short, round shape. After online research I found out that palpebral fissure elongation is feasible through an widening osteotomy to the lateral orbital rim. Is this really possible to make the eyelids noticeably horizontal longer, close to the photos that I have attached? If it isn't, does the eyeball size limit what can de bone? I've read that the orbital width is correlated with how long the eyeball transverse diameter is.

Mehryar (Ray) Taban, MD, FACS · Answer

There are definite limitations of how horizontally long the eyelid/eye can be and that is limited by the orbit. However, you can reduce the sclera show you are describing to give the eye more almond shaped appearance (rather than round). See following link and video.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. I suggest that you move forward and consult with your board certified facial plastic surgeon. There are various surgical and non-surgical options to address the eyelid. Please keep in mind that facial plastic surgery cannot address the underlying structure of your eyes.Best wishes,

Raymond S. Douglas, MD, PhD · Answer

You are asking very good questions. I believe what you are noticing is the shape of the lower eyelid probably more than the length of the eyelid( assuming no surgery in the past which is very important.) It is entirely possible to transform the lower eyelid shape to a more "normal" contour using orbital surgery --but this approach is not for everyone and carries risks. We recently published a paper looking at 152 orbital surgeries done in our office to restore a normal lower eyelid contour and appearance. (Ophthalmic Plastic and Reconstructive Surgery 2016). However this approach carries risks which include double vision and should only be considered when other options are unsatisfactory. We do this surgery a couple hundred times a year and you would want someone very experienced.

In summary you need a consultation to go over the options and risks by an oculoplastic and orbital surgeon. Be very cautious as few people do many of these cases.

In summary you need a consultation to go over the options and risks by an oculoplastic and orbital surgeon.  Be very cautious as few people do many of these cases.

Is horizontal eyelid (palpebral fissure) elongation possible on the Caucasian patient, through orbital surgery? (photos)

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