Fat Orbital Decompression?

I do NOT have Graves'. I have proptosis on my left eye due to trauma. CT Scan is normal. 1.5mm of protrusion. Am I a candidate for a fat decompression? can you elaborate on the purpose of the orbital fat, the fat decompression surgery, and the possible complications?

Doctor Answers 5


If you only have 1.5 mm of proptosis, and if in fact, your CT scan of the orbits is normal, then it is unlikely that your asymmetry is due to trauma.

The trauma that you attribute it to, is likely the reason you recognized a pre-existing asymmetry between the two eyes. As mentioned before 2 mm or less of asymmetry is considered to be in the normal range, and as such rarely, if ever is surgery done to address this.

You should consult an Oculoplastics/Orbital surgeon to properly assess your anatomy and discuss options for surgery, should it be warranted.

Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews


This is a complicated and inexact surgery. I would need to evaluate a patient with this type of request to determine if it 1) would be possible and 2) worth the risk. Proptosis is uncommon following trauma a more common finding is enophthalmos. You need to have orbital ct scans as well.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

It makes no sense to have a fat decompression for 1.5 mm of proptosis.

Generally it takes a minimum of 2 mm of difference in the projection of the globes to be discerned clinically.  It is possible there are other issues that are contributing to whatever it is that is bothering you.  Rather than prescribing your own treatment, it makes more sense to have a detailed consultation with an oculoplastic surgeons to assess what is going on rather than focusing on a particular procedure which may or may not be right for you.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Proptosis (bulgy eyes) and orbital decompression

In orbital decompression procedure, fat from the behind the eyeball in the eye socket (orbit) is taken out, similar to liposuction. It is an outpatient procedure which is done under sedation or general anesthesia.  Although the most common cause of orbital decompression is in those with thyroid eye disease, not all bulgy eyes are from thyroid eye disease, and this technique can be used for other causes of proptosis (bulgy eyes).   See an oculoplastic surgeon for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Cosmetic Fat Decompression for Traumatic Proptosis

                Oculoplastic colleagues gave good insight on this question in the past.  Complications would include double vision and blindness among others.  For cosmetic decompression without functional benefit, the risk benefit ratio is increased, and you should consider this when discussing with oculoplastic specialist.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

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