Am I a candidate for cosmetic orbital decompression surgery? What are my other options? (Photos)

Right eye is bulgy, left is flat. It looks bigger. The shape is different too. I don't know how to make them symmetrical. It looks like 2 different faces when I crop the pictures in 2. My right brow is more droopy too. It's annoying I have to lift it up all the time. I went to my doctor she didn't help me. She has to send a referral to the eye hospital so I can go to them for the cosmet orbital decompression surgery but I don't have contact with her anymore, it was my last appointment with her.

Doctor Answers 5

Large appearing eyes, options

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Your right eye does appear larger or more bulging than the left eye. And there is hollowness around both eyes that can make the eyes stand out more. You would benefit from filling around the eyes (fat or filler) and possible conservative cosmetic right orbital decompression (which only few expert surgeons perform). Need proper evaluation/discussion. See following link for more detailed information.

Appearance of bulging eyes

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Some people have very prominent eyes. Often this i caused by a medical condition called graves disease or thyroid eye disease.  But often it is due to trauma or just being born that way.  This can be quite concerning for many people in that it makes them appear intense or not normal.  Many patients ask if there is anything that can be done and in the past the answer was not too much at least safel

Now that is untrue. We specialize in moving the eyes back or improving this "bulging" appearance for patients using surgical and nonsurgical methods. This is specialized surgery that very few doctors would offer but our group has done thousands of these surgeries and our patients are very happy.  Bear in mind that not everyone has bulging eyes even if it can appear that way. 

The first step is a complete assessment which can often be started online.  Once you find out all the options including procedures to camouflage or reduce the appearance of eye bulging, you may decide moving the eyes is not something you want.  

You should have an evaluation by a qualified oculoplastic surgeon for evaluation and then consider all options. 

What you need is a careful oculoplastic assessment by someone who knows something about eyelids.

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Orbital decompression is not a cosmetic procedure.  Sorry.  Yes I know that there are folks out there offering exactly that.  However, it is for individuals with relative proptosis.  You do not demonstrate that.  What you do demonstrate is a hollow under eye circle and early upper eyelid levator disinsertion.  You also have a compensatory right eyebrow elevation.  Don't fall in love with a surgery that will harm you.

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

Orbital decompression

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Your best option is to enjoy your beautiful eyes! Everyone has a little bit of asymmetry - totally normal. Orbital decompression is a risky operation which would offer no benefit whatsoever, and possibly cause harm to your ocular motility and vision.


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This can be a tough thing to treat. First of all, every patient has asymmetries if you look closely. If you split face most people you will see a different person. 

Probably the most common cause of structural asymmetry in the bone is a hypoplastic maxillary sinus. This is not an issue medically only cosmetically. If you do have sinus surgery you should mention it to your surgeon though.

To diagnosis that you get a CT scan. There really is no good treatment for it. 

On the photos it appears your eyelids are symmetric? That can really only be determined with a good physical exam. Brow asymmetry is one of the most common asymmetries as the frontalis muscle is a wide fan like muscle that can result in asymmetric pull on the brows. 

 You have a very pretty face. I would not do much. If anything, you could consider some fillers to frame the eye if anything. It could be used to slightly lift the asymmetric brow possibly. Botox is also a noninvasive option.

Hope this helps.

Best of luck


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.