Surgery for big eyes? (Photo)

Thank you for your question. You submitted a photo, and say you hate your prominent eyes, and read about a procedure called orbital decompression. You state you have minus ten myopia, and ask what can be done to improve the appearance of your eyes.
I can share my perspective on your question, and, how I have this type of discussion in my practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I have plenty of experience with orbital decompression, with the most common cause for this surgery being thyroid eye disease or thyroid related immune orbitopathy.
I think there’s an opportunity here to appreciate some of the perspectives when looking at your face and your eyes. When someone has minus 10 myopia, that’s considered high myopia, meaning the shape of the eyeball is longer. When the shape is longer, as opposed to a smaller egg shape, it does have some contribution to the relative prominence of the eye. Sometimes I’ll ask  patients about their thyroid, and if they have a history of thyroid eye disease, they’ll tell me, “No, I don’t. Everyone thinks I do.” It’s either prominent eyes are a family characteristic, or they have high myopia with their eyes a little more prominent.
That said, another perspective to look at is the relative projection of your cheekbone. If the eye is looking relatively prominent relative to the cheekbone, if you draw a line straight from the cornea downward, and the cheekbone is behind, we refer to that as a negative vector, which comes into play when we discuss lower eyelid blepharoplasty.
What is also worthwhile considering is  enhancing the projection of the cheek. As many surgeons do, when think of surgical solutions, but we live in a time where we have a lot of non-surgical options. My first thought would be not a procedure like orbital decompression. Although it has been done for patients with high myopia, and it can work,orbital decompression is typically for excess fat or muscle thickness in thyroid eye disease, which you don’t have. You may be looking at bony decompression, which comes with a lot of significant risks.
When I look at someone like you, and coming from a facial cosmetic surgery background, I look at the face as a whole, and the eyelid and the cheek area, so I would consider Structural Volumizing as a non-surgical approach. This means using a long lasting filler placed in the bone level. With Structural Volumizing, you can enhance, and since you’re a younger person, we don't refer to this as restoration but rather some degree of enhancement or augmentation. You can enhance the volume of the cheek as it relates to the eye, and you may benefit from a little more balance.
When people don’t like something about their face, very often it’s a subtle amount of shifting of proportion that can create more of what is considered as aesthetically pleasing. My style to first try something less invasive before doing something more aggressive. I would caution you that when you have high myopia, you are at high risk for retinal detachment. Although there isn't necessarily a cause and effect with having manipulation of the eye, or surgical procedure around the eye and retinal detachment, that would be my concern because high myopia has the retina stretched. Relatively speaking, there are areas where the retina can be particularly thin with the risk of detachment, which is why people with high myopia see retinal specialists regularly.
That said, when you do something like Structural Volumizing with injectables in the cheek area, it leaves your eye alone. I think it’s worth considering, and it’s what I would start with before you consider other procedures like a submalar implant, infraorbital rim implant and other things. I think we live in a time where we have really nice injectables that can provide significant longevity such as a Juvederm Voluma or Juvederm Ultra Plus that can last over a year, and even longer, so learn about these options.
Find and meet cosmetic surgeons who have experience with this area. If you want to learn more about decompression, you want to meet with an oculofacial plastic and reconstructive surgeon, and try to get a sense of where you want to go. I hope that was helpful, I wish you the best of luck, and thank you for your question.This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Myopia, or near-sightedness, is likely the reason that you think you have large eyes. Though Thyroid Eye Disease is the most common cause of this condition, severe myopia is usually associated with larger than average eyeball size. I've performed a few decompressions for this reason. It is usually considered a cosmetic procedure however and could be very expensive.

The procedure will not change your myopia or affect your vision, but I believe from submitted view that your infraorbital rim position may be casting shadow on the lower eyelid creating the impression of "large eyes."  Orbital decompression is for other indications that you don't appear to have.  Infra-orbital rim augmentation is a two hour procedure that can produce lasting and dramatic results, some seen in our gallery.