Best way to correct orbital asymmetry? (Photo)

Question

As you can see from my photo, one eye is much higher in location than the other (but the brow is okay). Thyroid tests are normal and I'm trying to determine the best treatment options. I heard about augmenting the bone via orbital decompression but I'm more interested in possibly an implant to lift up the lower eye. For my case, which this be rather complex? Should I just leave it alone? It does bother me, especially in photos.

Kenneth D. Steinsapir, MD · Answer

You should be assessed to determine that there is not an issue behind the eyes that needs to be addressed.  This involves a consultation with an oculoplastic surgeon and usually orbital imaging.  Putting a silicone implant onto the orbital floor can lift the eye.  These are described but the surgery is seldom performed and the results are not predictable.  Typically it is a solution for situations that are more extreme than yours.  You do have left upper eyelid ptosis and this could be addressed with ptosis surgery which will improve the symmetry.

Paul S. Howard, MD · Answer

You're eye is lower on the left and you probably have a touch of enophthalmus on that side also. The problem is that your medial and lateral canthi on the left are also lower. Adding volume to the orbit may move the globe but the canthal ligaments will remain as they are and are very hard to move with the eyeball.What you are asking for is doable by any well-trained craniofacial plastic surgeon, but at what price? I would not recommend the surgery for you.

Elbert T. Cheng, MD · Answer

Hello,Thank you for your question and pictures.  I see the asymmetry that bothers you.  Everyone has asymmetry of the orbits, position of the orbits and bones of the face from one side to the other.  Yes, you could correct this with a craniofacial surgeon, but unless you are really bothered by this and obsessed with it, I would leave it alone.  But, consult a surgeon and have a examination to obtain all the pros and cons.  Best of luck!

Samuel Baharestani, MD, FACS · Answer

Thank you for sharing your photo and questions.  I find it difficult to appreciate the asymmetry that bothers you because of the two dimensional image and the shadow across your face.  Schedule a consultation with a board certified oculoplastic surgeon to discuss your concerns and examine the bones around your eyes.  Sometimes, imaging with a CT scan is necessary.  Good luck!

Gaby D. Doumit, MD · Answer

You need to be examined by a craniofacial surgeon. Your problem can be easily corrected. It is not complex. We need to find out whether it was from birth or recent. A Ct scan of the orbit will tell us the cause and then dictate the treatment.

Henri P. Gaboriau, MD, FACS · Answer

Unfortunately, it looks like bone asymmetry which I would NOT recommend to  touch. An implant could shit posterior  and put the optical nerve in serious jeopardy. Sorry not to have a better advice but I would leave it alone!

Best way to correct orbital asymmetry? (Photo)

Answers (6)

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