Can Mild Orbital Dystopia Be Safely Treated?

Q: Dr. Eppley, I am contacting you because I would like to know if it is technically possible to effectively treat a mild orbital dystopia at this time. I can only find very little satisfactory information on this subject on the Internet. I have a general facial asymmetry, my face is globally asymmetrical, and even though it is not obvious or abnormal, it is in fact unsightly. It’s a complex that I’ve been carrying around for a long time and it’s proving to be psychologically very difficult to overcome. I know it’s a complex and delicate problem, and from what I’ve read on the internet, it’s difficult to treat and rather risky, but I can’t bring myself to give it up. Thank you for taking the time to read me, I hope you have a great day.

A:You are referring to what I call aesthetic vertical orbital dystopia (VOD less than 5mm horizontal pupillary difference) which is neither overly complex to treat nor risky. The pertinent issues with aesthetic VOD are 1) how many periorbital components need to be treated for an effective improvement (orbital floor augmentation alone is almost never adequate), 2) how effective will the procedure be and 3) will any revisions be needed. Preoperative assessment includes a frontal facial picture as well as a 3D face CT scan for treatment planning purposes.

Dr. Barry Eppley

Indianapolis, Indiana