What Is The Best Method To Correct My Orbital Asymmetry?

Q: Dr. Eppley, I am making contact to inquiry about the Correction of Eye/Orbital Asymmetry, as you will see from the attached photos I have some degree of Eye/Eyebrow Asymmetry, So it be great if Dr. Eppley could review my photos and see if he could help with minimizing my Asymmetry. A case study that I think is simpler to my case is: https://exploreplasticsurgery.com/case-study-correction-of-eyeorbital-asymmetry-with-hydroxyapatite-cement/ I look forward to your response.

A:In the treatment of vertical orbital dystopia (VOD) it rarely is so ‘simple’ as augmenting the orbital floor and rim and all turns out well. Having treated many VOD patients the lessons learned are that the entire orbital box and eyelids have developed around the eyeball where it sits. If you just raise the eyeball it will get buried underneath the upper eyelid and the eye will have increased scleral show inferiorly. (in other words the eyelids have to be adjusted as well) As you can see in the attached diagram all of your bony and soft tissue orbital structures are positioned lower. Thus a more comprehensive approach is needed to get a more effective result. Today VOD is usually treated with a custom orbito-malar implant (see attached) usually combined with upper and lower eyelid surgery and a right endoscopic browlift.