What Procedures Do I Need To Improve My Vertical Orbital Dystopia?

Q: Dr. Eppley, I am writing to you because of my facial asymmetry, especially of the eyes, that I am looking to correct. My right eye is positioned lower than the left one and canthal tilt is more negative. Furthermore, my right eye is more hooded and its superolateral orbital ridge sits lower. While my right cheek area lacks volume, on the right side my jaw is more prominent. I was thinking of cheek (right side) and jaw (left side) implants. Concerning my right eye, I was thinking of canthopexy or canthoplasty and brow lift, maybe even orbital floor implant and reduction of the superolateral orbital ridge. What procedures do you think would be most effective in achieving a more symmetric appearance? And what steps would I have to take next to plan surgery with you. 

A:Everything you have described is classic for a right vertical orbital dystopia (VOD) including the procedures you have mentioned to address it. An assessment of which VOD and other procedures may be beneficial requires a picture assessment (front view) and a 3D CT face scan which I assume you have not yet had. (you should be able to get that in your country)

Once I have that information I could provide an informed opinion about what the optimal corrective procedures may be. Usually the front view pictures tell us what we need to do and the 3D CT scan provides confirmation of those bony needs as well as serves as the platform on which to build any implants if needed.

Dr. Barry Eppley

World-Renowned Plastic Surgeon