Are Orbital Box Osteotomies Dangerous?

Q: Dr. Eppley, I have read from some sources that orbital box osteotomies is an extremely risky procedure, but have read elsewhere that the risks are over exaggerated. Can I please ask for your opinion of the risks involved? Also, are there any alternatives that you know of that can increase interpupillary distance?

A: From a medical standpoint I would not consider orbital box osteotomies as particularly risky, although it does require a frontal craniotomy to perform. From an aesthetic standpoint, however, there are going to be some tradeoffs. (bony irregularities, long coronal scalp scar) And 100% of orbital box osteotomy patients (children, teens and adults) are going to need revisional surgery to improve any of the aesthetic tradeoffs. Thus like all aesthetic surgery, which always trading one problem for others, the decision for surgery is balancing the benefits vs the risks.

Dr. Barry Eppley

Indianapolis, Indiana