What Are The Risks of Vertical Orbital Dystopia Surgery?

Q: Dr. Eppley: I have some questions about vertical orbital dystopia (VOD) surgery which I would appreciate if you could answer for me.

1. For VOD surgeries like mine, what risks/complications should I be aware of?

2. Out of all the VOD surgeries you’ve performed, have you seen any cases of severe or irreparable complications (e.g., loss of eyesight, severe nerve damage, etc.)?

3. I got a second opinion from another surgeon, who recommended against an implant, saying it involves too much risk.  He recommended I proceed in stages – trying blepharoplasty + brow lift + fat transfer first to see if I’m satisfied with that. I am skeptical this would give satisfactory results, but what are your thoughts? If we did something like this, would we still have the option of adding the implant later?

4. I feel unclear on some important details of the surgical plan, like where the incisions will be made, where the brow bone will be reduced, etc. Do you have an article or other description of these procedures that closely matches what you are planning in my case? Or how can I best get educated on these details? (I have been reading articles on the website, but don’t know how closely they apply to my case.)

A: In answer to your VOD questions:

1) The major risks are aesthetic in nature and mainly revolve around how well the eyelids follow the eye superiorly. In VOD perfect symmetry is rarely obtained, it is a question of the degree of improvement.

2) I have never yet experienced any significant complcations from this type of orbital surgery.

3) I can only comment on what I do. I can not speak for other surgeon’s experience or techniques. Certainly doing the procedures that have even mentioned can be done as they do not burn any bridges for doing other procedures later.

4) I would go to www.exploreplasticsurgery.com and search under vertical orbital dystopia where the procedure is fairly well explained, both in description and with pictures.

Dr Barry Eppley

Indianapolis, Indiana