Dominant Eyes, Protruding Eyes, Hooded Eyes, Which Do I Have? (photo)

Question

Ive been teased about my eyes my entire life & Im on the fence regarding surgery. Im trying to understand what it is about my facial features that sets me apart. I think my eyes are too prominent (Ive been tested and am sure its not due to a thyroid issue), that my cheeks are too full at the bottom and my cheekbones are not prominent enough, and that the space between my nose and upper lip is too great. If I had surgery what would make the biggest impact? Your opinion is greatly appreciated.

Jed H. Horowitz, MD, FACS · Answer

Yes, you do have prominent eyes. although i do not do decompressions. you would benefit from this. you don not have hooding but thick heavy upper lids which can be reduced and thinned. your lower lids can be filled or have fat transposition but none removed and care not to tighten the orbicularis much .

Mehryar (Ray) Taban, MD, FACS · Answer

You are correct about the problems you address. The most effective procedure is orbital decompression to set the eye back with likely midface and lower eyelid lifting. Consult an oculoplastic surgeon.

Chase Lay, MD · Answer

You can certainly be helped and this can be improved.   I see your entire face here; your pictures are helpful.    Here's what I can tell you.

	1.  Orbital decompression for you is a great option, I do it all the time but more often for Grave's disease than cosmetic purposes, but the techniques are the same.  This would deproject your eyes a bit and that would look great.  Here's the thing though; you don't want to over do it and have your eyes be to sunken.  If it's too agressive you'll notice a difference not only in the appearance of your eyes but your upper and lower eyelids. It just needs to be done with care.   There are a few other things that would improve the who complex that is your eyes, nose, and cheeks.

	2.  Nasal dorsal augmentation.  I noticed on your profile the deepest part of your nasal bridge (called the radix) at the level or your eyes is a bit deep and this adds to the projected appearance of your eyes.

	3.  Your orbital rim (bone ring around your eye) is a little week inferiorly as are your cheeks anteriorly just under your eyes.  This also adds to the projected appearance of your eyes.

	So you can do a few things.  A:  Just do the decompression, conservatively but effectively, and if you love it, great!  No need to do anything else.  B:  The decompression looks good but it's not quite enough.  In that case you may consider some augmentation procedures of your nasal bridge and/or your malar/midface area.  

	Best of luck

	Dr. Chase Lay

Vincent P. Marin, MD, FACS · Answer

You have a number of options regarding your "prominent" eyes. Decompressing the orbit is most likely to be the most effective option as well as alternatives such as fillers to camouflage the appearance. However, you should be careful regarding any eyelid surgery as you are a higher risk patient for postoperative complications. See an ophthalmic surgeon who specializes in thyroid eye disease - although you may not have it, the treatment will be similar.

Best of luck.

Best of luck.

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