Your Questions
Your Questions
Q: Dr. Eppley, I am a 22 years old male and am interested in the orbital reshaping/brow bone reduction process. I had a procedure done a year ago, it was a frontal sinus reduction. This procedure didn’t really accomplish much. I didn’t stress to the doctor the type of results I was after. I guess looking back, I have myself to blame. I have attached pictures which show most of what I’m unhappy with… the somewhat uneven/large orbital rim. I would like to smooth that down to create a simple and more attractive looking eye area.
A: Thank you for sending your pictures. Knowing that you went through a major frontal sinus reduction procedure, there must have been some miscommunication as to your outcomes. While I don’t know what you looked like before, my assumption is that what was achieved was some high frontal sinus/brow setback. But you were as much interested in the lower frontal and lateral setback as well. In your previous procedure, do you know how it was done? Was the bone taken off and put back with small plates and screws, wires etc?? That may have an impact on how well further reduction can be by hardware being in the way, scar tissue, etc. There is also the issue of how much bone along the orbital rim can be reduced without entering the frontal sinus. This is the value of the frontal sinus osteotomy technique which overcomes this limitation. Orbital rim reshaping/brow bone reduction is more of a burring technique although some features of an osteotomy technique can be incorporated into it.
Dr. Barry Eppley
Indianapolis,Indiana
Q: I am currently faced with several problems. My face looks wide because I have prominent cheekbones. I have deep set eyes because of very prominent and bulgy orbital rims. It’s not so much the width of my face that bothers me but it brings everything out of place. Because of the small eyes and the rest of my face is pretty crowded together. When looked from the side, the orbital rim covers nearly everything of my eye while other people still have a part of the eye visible. My cheekbones are bulgy both in the front and the side. Is there any procedure to help me?
A: What you are referring to is prominent orbital rims which make up 3/4s of the orbital ‘box’ that encases the eye. When this outer circle of bone is prominent, it makes the eye seem deep or hidden. It is possible to reshape the orbital rims, particularly the brow bone (upper orbital rim) and the side. (lateral orbital rim) It is not so much whether it can be done but whether the trade-off for doing so is worth it. To surgically access this area, a scalp or coronal incision is needed. This allows the skin to be lifted to get to the area for reshaping. For many women this is not a rate-limiting consideration. But for many men it understandably is.
The width of the cheek bone can be narrowed by a vertical wedge bone removal right below the eye bone which is done from inside the mouth.
Indianapolis Indiana
