Is It Possible to Get Cosmetic Orbital Decompression for Inherited Protruding Eye? (photo)

Yes, cosmetic orbital decompression is definitely possible to reduce bulgy appearance of the eyes. It is best to see an oculoplastic specialist for evaluation. Complimentary filing around the eyes is also helpful, if needed.  See link below.

As mentioned, you have a triad of anatomic issues here: 

1. Prominent eyes [proptosis or exophthalmos]

2. Midface weakness [hypoplasia]

3. Upper eyelid droop [ptosis]

All these features can be addressed surgically, probably best in a staged fashion.

An orbital decompression can help set the eyes back. This can be done via a bony and/or a fat decompression. There is some risk of double vision here, but it can be minimized by only taking bone from the lateral orbital bone [sphenoid].

This would definitely improve the bulginess, but it could exacerbate the droopy upper eyelid.

The midface augmentation with implant or fat grafting can be considered as well.

I would recommend seeing an Oculoplastic surgeon that is comfortable in all these techniques. In Seattle, we see many patients from our neighbors in Vancouver

Not necessarily the best option though.

Robert Goldberg at UCLA probably has the most experience with this.  However, I think you could have a great deal of help with orbital rim filler to build up the orbital rim and cheek.

Orbital decompression surgery is typically performed when the muscles around the eye become swollen and may compress the optic nerve.  This is often related to Graves’ disease (a thyroid disorder).  The surgery creates space for the swollen muscles to relieve pressure and prevent damage to the optic nerve.   This is a fairly major surgery and I would not usually recommend it solely for cosmetic reasons, particularly before more conservative treatment has been tried.  From your photos, it appears as though you might get nice cosmetic improvement from performing a lower eyelid retraction repair surgery.  This would raise the lower lids and eliminate the white of the eye that is now visible below your iris (colored part of the eye), which causes the eyes to look protruded.  This is a less invasive surgical option that would only take about 45 minutes total to perform on both lower eyelids.    

If you have not already had one, I would also recommend getting a thyroid work-up by your internist and/or an eye doctor with expertise in Graves’ disease.  Because exophthalmos (protruding of the eyes) is commonly associated with this disorder, it is good to have this checked in case any other medical treatment is warranted.

Hi and thanks for your question.

Based on the photos that you have provided it looks like you have a flat cheek bone ( midface hypoplasia) and Bilateral upper eyelid ptosis. The only way to confirm whether your eyes are protruding is by a test performed by your PS using an Exophthalmometer.

If you do have a protruding eye then you can discuss with your PS regarding orbital decompression. If the ptosis and midface hypoplasia are the more dominant issues then ptosis correction by surgery and augmentation of the midface using implants or fillers may be options.

Hope this helps