Is A Custom Orbital Floor-Rim Implant A Good Treatment For My Vertical Orbital Dystopia?

Q: Dr. Eppley, I’m in the UK and have been unable to find a surgeon to improve my orbital dystopia here to get an improvement in my eye asymmetry. Would I be able to send you a picture of my eyes & an image from my CBCT scan to see if you would be able to assist me? I am very nervous about considering surgery outside of the UK but would like to know if it’s at all feasible for me. I would like to get an idea of the cost of an infra-orbital rim implant (possibly combined with cheek implants). As if an implant is an option in my case I would be very keen to do so. 

A:Thank you for your inquiry and sending your picture and 3-D CT scan. Almost every custom vertical orbital dystopia implant is a combination of the orbital floor, infraorbital rim, and cheek as the entire composite bone unit is situated lower. While  this would be effective in your case based upon the amount of millimeters that the left eyeball is lower than the right, 5mm or less, it is important to understand that you cannot just move the eyeball alone as the eyelids are not going to follow it upward. Thus  almost every vertical orbital dystopia patient requires concomitant upper and lower eyelid repositioning with their custom implant. Fortunately, your left eyebrow is minimally lower than that of your right and does not require management.

Dr. Barry Eppley

World-Renowned Plastic Surgeon