Orbital Decompression and Custom Orbital Rim Implants for Orbital Proptosis and Psuedoproptosis

Q: Dr. Eppley, I am a 43 yr old female seriously interested in orbital decompression surgery and I believe I may need eyelid retraction surgery as well. I follow Dr.Eppley on Instagram.  He advised me to seek a local oculoplastic surgeon to address my concerns. There are 2 in the city of Memphis, TN.  After consulting one, he admitted he had very limited experience performing the surgery because there isn’t a demand for such a surgery in my city.

I do want to ask some questions, prior to my consultation, if I may? If you can answer any of the following, that will help me to narrow down my questions during my virtual consultation.

I have included pictures to assist you or Dr. Eppley in hopefully answering my questions.

Here are some of my problems with my eyes:

*I have my thyroid tested annually, my last test said all my numbers were in the normal range.

1Bulging – it appears to be getting worse as I age.

2. Excess skin or fat on my lids. Hooded eyes – I do not like it. I do not like it!!

3. Inability to close my eyes fully when I sleep.

4. Asymmetrical eyes – sometimes it is so drastic.

5. Double bags under my eyes when I smile.

6. Eye shape – my down turned eyes ages me, in my opinion. Can an eye shape be changed during surgery?

My goals would be to fix those aforementioned problems.

The questions I have are as follows:

1)Am I candidate for orbital decompression surgery?

2) How long is the recommended stay for out-of-town patients?

3) Does private insurance cover orbital decompression surgery? (I have Cigna, which is out of network).

4) If insurance does not cover any of the costs, how much roughly would it costs for the procedures I have listed and/or any procedures Dr. Eppley deems necessary?

I greatly appreciate your time and consideration.

A: In answer to her questions:

1) I think you ideally need the following combination of procedures:

     a) orbital decompression

     b) upper blepharoplasty

     c) lateral canthoplasties

     d) orbital rim augmentation

    While you may have orbital proptosis, there is also a signficant contribution of infraorbital rim/midface deficiency.

2) Patients usually come home in a few days after the procedure. Recovery is largely about swelling and its resolution.

3) I do not take insurance

4) My assistant Camille will pass along he cost of such surgery.

You would need a 3D CT scan to determine the bone anatomy as well as a preoperative ophthalmology evaluation that determines you do not have a metabolic basis for your orbital proptosis.

Dr. Barry Eppley

Indianapolis, Indiana