Can My Vertical Orbital Dystopia Per Fixed?

Q: Dr. Eppley, I have VOD (right eye lower). I will send (attach) photo. can it be fixed? I am planning on getting the right eyebrow lifted with botox next week (I have done this before), which kind of helps to even things up, but as you can see, the pupils do not line up horizontally at all.

A:Thank you for your inquiry and sending your picture. When the eyebrow is raised the perception of VOD becomes more apparent. Unlike raising the eyebrow with Botox injections, however, lifting up the eye requires more effort. Elevating the eye also requires adjustments of the upper and lower eyelids that drape over and around  it. As a result it takes a combination of four procedures to satisfactorily do so including an orbital floor-rim implant for globe elevation, lateral canthoplasty for raising  the outer corner of the eye with spacer grafts of the lower eyelid and upper lid level elevation. (ptosis repair)

I never few VOD surgery as a ‘fix’ as ideal symmetry between the eyes can never be achieved. Rather it offers an improvement than lessens the perception of the VOD.

Dr. Barry Eppley

World-Renowned Plastic Surgeon