I Want to Get Rhinoplasty and Orbital Decompression but I Dont Know Which First?

hello! i have my eyes bulged out and my self-steam is low. I don't like the way they look. Another think i have is a big nose tilted into the other side and this bothers me too. I am not sure which surgery should i go first, orbital decompression or rhynoplastic surgery. Please help. can they be performed the same time. How much is orbital decompression will it cost me?Thanks

Doctor Answers 6

Orbital decompression done before rhinoplasty

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It is always best to have medically related procedures performed first and elective cosmetic procedures preformed later.  Orbital decompression is typically done out of medical necessity and is billed to the patient’s medical insurance.  It is important to address any underlying medical conditions that may be causing the eye protrusion.  Wait a few months after orbital decompression to undergo rhinoplasty.

Orbital decompression

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Do your homework on the orbital decompression procedure.  It is usually done for eyes that bulge from either  thyroid condition or a true craniofacial disorder.  It should not be undertaken lightly and only by a surgeon experienced with the procedure.  I have never done one and I've been practicing for 25 years, nor have I ever had a patient request it  If I did see a patient who really needed it, I would refer it to someone who is is an experienced craniofacial expert.  I would advise against it if done for mild orbitial proptosis.  It would really help if you submitted photos.

Orbital Decompression and Rhinoplasty

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I would do these 2 procedures at different times. It would be best to do the decompression first because the changes in your eyes may influence aesthetic choices with your nasal surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

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Orbital Decompression Before or After Rhinoplasty

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These two procedures should be done separately both for recovery and aesthetic reasons. The orbital decompression should be done first as this appears to be the most bothersome to you. Also once the eye appearance is improved your concerns about the nose may change, either convincing you that it is not needed or reinforcing that a rhinoplasty would be beneficial.

Orbital decompression should be done first, then later rhinoplasty.

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Orbital decompression may be performed by oculoplastic surgeons, plastic surgeons, or facial plastic surgeons, each of which may have varying degrees of expertise with cosmetic rhinoplasty.

I'd do them separately, with the expert surgeon chosen separately for each procedure. Start with the orbital decompression first, as this may affect aesthetic decisions regarding your nose. Best wishes!

Orbital decompression with other surgeries

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Morning Tony1,


The could be performed together but your recovery may be a little rough.  As a surgeon who performs both these procedures but orbital decompression more frequently.  It's not for the faint of heart and it does carry some risks.  You should see a few oculoplastic surgeons before moving forward.  There are very few surgeons qualified to perform both at the same time.  Generally, I'd say perform them separately.


Dr. Lay

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 76 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.