Eye Surgery Consult

[Austinou88]

So, I just recently had a consult with the eye expert out in LA. He recommended Ptosis Surgery (as expected) but also had told me something very interesting.

He said that my eyes were sunken back, and that he could do Bilateral Orbital Implants to bring them forward. They would be placed on the Orbital Floor. (as this is the only safe location to place the implants)

He said in my case, he'd bring my eyes forward about (3 to 5mm). Usually this is done on patients for Orbital Blow-Out Fracture Surgery And Enophthalmos (Sunken Eyes). But he said he's done it on Non Fracture Patients, but it's something he obviously doesn't like to advertise.

He can't show me any before/afters, and he doesn't have the software to show me any kind of morph.

I had a followup appointment, and he said that it's not something I have to do, and that he thinks he may want to try and talk me out of doing it now. Any thoughts on this?

The procedure is reversible is what he said, but its difficult to begin to consider when you aren't even sure how you would look post op.

[Dogmatix]

I would not put anything to push my eye in any direction. I know the feeling of having a contact lense sitting wrong. Having an implant on the orbital floor seems crazy. And also I would never mess with my eyes, stakes are way too high.

It's also a very strange proposal from the doctor. First bringing it up on the table, saying you would benefit from it, then saying you dont have to do it, and lastly wanting to talk you out of it. It's like he want to do it for his own joy, but also want to be able to tell you after that he tried talking you out of it. If he really don't want to do it, it would make more sense to not even bring it up, and only offer it to patients who bring it up them selves.

[Lazlo]

I would do it if he could somehow do it without having to place a synthetic implant. Like if he could graft bone or fat or something.

[Austinou88]

I would not put anything to push my eye in any direction. I know the feeling of having a contact lense sitting wrong. Having an implant on the orbital floor seems crazy. And also I would never mess with my eyes, stakes are way too high.


It's also a very strange proposal from the doctor. First bringing it up on the table, saying you would benefit from it, then saying you dont have to do it, and lastly wanting to talk you out of it. It's like he want to do it for his own joy, but also want to be able to tell you after that he tried talking you out of it. If he really don't want to do it, it would make more sense to not even bring it up, and only offer it to patients who bring it up them selves.

There are risks involved, and he did give me percentages. It's all very low though, something I myself would accept and move forward if it would give me a beneficial look post op.
There is a possibility of too much pressure on the eyes from the implants, and the surgery is reversible. Just something else to consider in the risks, which are all very low. 

I was actually the one who brought up everything, he only put out options. I couldn't even get him to make reccomendations on what to address, besides Ptosis. He told me changes to the eyes is all personal choice and your own perception. So again, I couldn't get him to reccomend anything to me.
He only offered the Bilateral Implants (a very uncommon thing done for non fracture patients) after I said my eyes/eyeballs were small and beady. He said they looked sunken back a little bit, and this is something that could move them forward

[Austinou88]

I would do it if he could somehow do it without having to place a synthetic implant. Like if he could graft bone or fat or something.

How do you think it would look though? I mean isn't the whole goal to have setback eyes. How is bringing mine forward not make them look worse?

[Lazlo]

How do you think it would look though? I mean isn't the whole goal to have setback eyes. How is bringing mine forward not make them look worse?

I think yours are on the opposite end of the spectrum, too set-back which is what makes them look so small. This would fill out the eye-socket a little. I still think your interpupillary distance is also low. You can just get that measured at most eye-glass places. Most of them have a device they put on your face and measure it in seconds. It doesn't cost anything. It would be interesting to find out for sure what's the source of the problem.

[Austinou88]

I think yours are on the opposite end of the spectrum, too set-back which is what makes them look so small. This would fill out the eye-socket a little. I still think your interpupillary distance is also low. You can just get that measured at most eye-glass places. Most of them have a device they put on your face and measure it in seconds. It doesn't cost anything. It would be interesting to find out for sure what's the source of the problem.

Yeah he did they say were a little too set back. I'll try and get in with the eye doctor asap, and find out. When I asked him at my consult about my IPD, he had a hard time giving me a yes or no on if they were close set or not.

My PD from an old old eye prescription says 56.0 on it.

[Lazlo]

Yeah he did they say were a little too set back. I'll try and get in with the eye doctor asap, and find out. When I asked him at my consult about my IPD, he had a hard time giving me a yes or no on if they were close set or not.

My PD from an old old eye prescription says 56.0 on it.

Yeah so your IPD is kind of average. It's not on the super low side. So maybe Taban has a point that your eyes are set too far back and that will fix your problem.

[Austinou88]

Yeah so your IPD is kind of average. It's not on the super low side. So maybe Taban has a point that your eyes are set too far back and that will fix your problem.

I've asked people directly if my eyes were closeset. They tell me no, that they're just small. Yeah maybe. It's just hard to know what I'll end up looking like. You still think it's still something to consider.

[Lazlo]

I've asked people directly if my eyes were closeset. They tell me no, that they're just small. Yeah maybe. It's just hard to know what I'll end up looking like. You still think it's still something to consider.

I would definitely consider it for you if it bothers you.

[Austinou88]

Yeah I definitely am close to scheduling it. If he recommended it, then it's probably a good idea right? You ever of this being done?

[PloskoPlus]

Yeah I definitely am close to scheduling it. If he recommended it, then it's probably a good idea right? You ever of this being done?

Taban's results are pretty good. He, like other oculoplastics, has a very low risk threshold.  IMO, much lower than most maxillofacial surgeons.  Most of his work is quite the opposite - making eyes less prominent.  Even so, I think it still gives him a lot more experience than everybody else on how the eyes look when the orbital volume changes.

How close set the eyes are is a function of eye width.  If less than an eye width fits between your eyes, they are close set.  If more  - wide set.   I don't think this surgery has any impact on eye width, and definitely has no effect on the distance between your eyes.

I would ask him if the surgery is reversible and if he would reverse it for free given, how on the fence he's about the whole thing.  I'm kind of thinking he wants you as an experiment.  So if your case works out, he'll start offering it more. Hell, I'd ask him to do the surgery (and any revision) for free or for a much reduced price. 

If it does work out, it could be a game changer for your looks. The eyes are the windows to the soul.  Chins, "gonial angles" are small details in comparison.

[Austinou88]

I would definitely consider it for you if it bothers you.

Also, what determines eye attractiveness? He does so many different types of things, but he won't really recommend anything. He said it's all preference, so if he won't really recommend anything, how am I supposed to know what would improve a bad eye area.