Can Orbital Box Osteotomies Be Done To Make My Eyes Wider Apart?

Q: Dr. Eppley, How much would an orbital box osteotomy cost for eyes that are too close together performed at your clinic? I am extremely motivated to have one, because my face is dramatically disharmonic due to this defect: my interpupillary distance is only 5.9 cm, my intercanthal distance is shorter than an eye breath and my face appears long and narrow. What are the effects of such an operation in the cheekbones area? Thank you,

A: Thank you for your inquiry. The most important issue to recognize about orbital box osteotomies is that they require a frontal craniotomy to perform. As a result the following sequelae exist: 1) a full coronal scalp incision is needed, 2) it must be performed in a hospital with several days of stay, and 3) there will be resistant bony irregularities/edges n the cheek and forehead areas around the osteotomy sites where secondary revisional surgery is likely. All of this together means it is highly expensive (patients only do it through insurance) and there are aesthetic tradeoffs that one must consider very carefully. This is why this is a procedure that is almost always only performed in craniofacial deformities where the magnitude of the deformity justifies the aesthetic tradeoffs and surgical risks.

I would need to see pictures of your face to determine how the above statement falls in line with the extent of your inter orbital concerns.

Dr. Barry Eppley

Indianapolis, Indiana