What Advancements Do You See For Orbital Box Osteotomies For Aesthetic Eye Distance Changes In The Near Future?

Q: Dr. Eppley, Based on your experience and where craniofacial surgery is realistically headed, do you expect limited orbital widening for normal anatomy (beyond very small changes) to become meaningfully safer or more justifiable for cosmetic use in the next decade or do you see the risk–benefit balance staying essentially the same?

A: For eye widening using limited orbital box osteotomies already exists (inferior orbital box osteotomies) or can be done with 3/4 orbital box osteotomies using a coronal scalp incision if the patient can tolerate the fine line scalp scar. Both approaches avoid a frontal craniotomy which is what separates a more limited approach vs a major craniofacial surgery which is more justified in more severe craniofacial deformities. 

It is eye narrowing on which the intracranial orbital box osteotomies can not be avoided for any degree of effectiveness.

I don’t see these approaches changing much in the foreseable future. The  partint demand is low so the need for innovation for a limited market is likewise very low. 

Dr. Barry Eppley

World-Renowned Plastic Surgeon.