Is Cosmetic Orbital decompression right for me? (Photos)

Question

I'm a male in his 20s and I have and have always had large eyes. They are a genetically acquired trait as one of my parents has similarly large eyes. I feel as though my eyes are out of proportion with the rest of my face and at times appear protruding. I am considering cosmetic orbital decompression to set the eyes farther back. Please see the photos I've attached and tell me if this would be a beneficial procedure to consider. Thank you! -Michael

Kenneth D. Steinsapir, MD · Answer

How high is high? The risk of getting on a commercial passenger jet that crashes in about 1 in 3 million.  Most of us accept that risk. The risk of getting on a commuter plane is much higher: about 1 in 500,000 flights. Many of us get on these planes without a troubling thought. Jumping out of a plane has a risk of death of 1 in 100,000 jumps.  Many of us are not interested in that risk, some accept that risk.  What about base jumping.  That is the sport where you stand on the edge of a large cliff with a parachute on your back and you jump off.  This is very popular in Norway at the Kjerag Massif. Perhaps you have seen videos of this.  There is a detailed study of this site between 1995 and 2005. In 20,850 jumps, there were 9 fatalities.  That is a risk of death of 1 in 2,317 jumps. Most of use find that risk too high to engage in this activity. How about risks associated with orbital decompression? This work is done in an accredited hospital or surgery center operating room under general anesthesia. That has a risk of death of about 1 in 50,000 cases.  Many would accept that risk for cosmetic surgery.  How about the risk of going blind in an eye from the surgery? The risk of this is not fully studied but there are a number of studies of orbital surgery that give us an approximation of this risk, which is between 1 in 500 to 1500 cases. There are individuals from whom this risk might be acceptable. It is not a clinical decision that should be made in a Skype consultation. Based on your photos, I do not think it will be beneficial for you. However, the world we live in, if you knock on enough doors, someone will accept you as a patient. Caution is advised.

Mehryar (Ray) Taban, MD, FACS · Answer

The appearance of bulging eyes can be due to position of the eyeballs or hollowness around eyes. Filler injection around eyes is a possible noninvasive option to make your eyes less protruding appearing. Cosmetic orbital decompression is a more invasive treatment option but consultation is needed to determine if necessary.

Farhad Ardesh, MD · Answer

Hi Michael, Orbital decompression is a major surgery performed for medical conditions such as graves thyroid disease. Orbital decompression could either mean removing the bone around the orbit (through the nose, and incision along the crease of your eyelid) or removing intraconal fat from around the eye.  These surgeries have risks of bleeding and blindness.  Based on the photographs you provided it does not appear that you have significant proptosis.  i’m not sure if surgery in your case is worth the risks. You will require in person consultation for this kind of major procedure. I hope this helps and I wish you the best, Dr. Ardeshirpour

Is Cosmetic Orbital decompression right for me? (Photos)

Answers (3)

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