Eye Asymmetry Surgery
Q: Dr. Eppley, I am interested in eye asymmetry surgery. I was born with congenital torticollis. The torticollis was not caught early and resulted in me sleeping exclusively on my tummy with the left side of my head smushed against the mattress as a newborn/infant which resulted in the asymmetry in my face. My head/neck as a baby would not turn to the left due to the torticollis. I had a plastic surgery consult when I was 12 and we decided to correct the torticollis (by releasing my left side sternoclatomastoid muscle) but the other facial reconstruction freaked me out too much. At that time, it involved significant intracranial work and taking bone from my ribs and raising eyeball …in short it was overwhelming to a 12 year old so I told my parents I didn’t want to do it.
I now feel that with age my right side has become too bulky and my left side seems to be sinking in more which is causing the eye asymmetry to be more noticable. When I was younger, you didn’t notice as much, as the baby fat was more evenly distributed in my face.
When I saw your case study with the Hydroxyapatite cement, it gave me hope that there might be a less invasive fix to even out my eyes?
A: Thank you for sending your pictures and detailing your history. The treatment of eye asymmetry or vertical orbital dystopia (VOD) that has a 5mm or less discrepancy can be done through orbital floor/rim augmentation as well as some surrounding ancillary procedures of the eyelid, cheek and brow bone. (eye asymmetry surgery) A 3D CT scan is very useful in determining the vertical discrepancy and how much orbital floor augmentation would be needed and/or can be done. In many cases of VOD my preferred method is a custom designed implant that covers the orbital floor crosses over the infraorbital rim and onto the cheek…all orbitofacial skeletal areas that are deficient in all cases of VOD.
Dr. Barry Eppley