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can a mid face lift do anything to reduce appearance of proptosis
I have slightly bulging eyes due to combination of possibly thyroid and very high myopia on eyes that were large prior to either problem. MRI reveals no thryoid involvement but because I have hashimotos Dr's say it may contribute. Eyes don't seem to be changing. I am 37. Borderline for orbital decompression - some Dr's will do it, others say my eye problem is too mild. proptosis is 19 and 20 mm. eyes dry but only on waking and in the wind. Eyes don't bulge noticeably out of sockets as such, because they have pushed the eyelids outwards, rather than much retraction so main problem is under eye hollows and puffy lids. Would a midface lift help the appearance of proptosis at all..and even possibly reduce the dry eye a little by reducing the 'pull' of the sagging cheek on lower eyelid? In hope!!
A midface lift will not help, in fact may hurt you more. What you need is permanent fat grafting to the lower lid and cheek area and even eye brows. This will definitely improve your appearance and I am stating this even without your photos being posted, which BTW would help.
Good luck from NYC
Thank you very much for taking the time to answer my question...can I be cheeky and ask your opinion on the surgery proposed?
The full surgery proposed is: spacer graft (taken from roof of mouth) to one eye which is slightly larger, mid face lift, then fat transfer to the hollows under the eyes (i think the surgeon mentioned over the eyes too). In tandem with these other procedures, do you still feel a midface lift could possibly be something likely to have an adverse affect...it was actually me that requested the inclusion of it...rather than the surgeon, so if its not a sensible thing to push for, i'm glad i asked.
In my opinion no one should have a midface lift. Fat transfer, in experienced hands can create more and better results with practically no risks. The eyes should get so much better as well, so postpone the graft. That procedure should be reserved for some one after a disaster of some kind.
I must admit, I don't like the idea of the palette graft. Final quick question..can fat transfer do anything at all to assist the very slight dry eye I have caused by the proptosis ? I know that seems an odd question but i wondered whether, with more fat in the under eye area (the area that currently seems hollow)the lower lid might be very slightly pushed upwards to cover the eye a little more. Thank you so much.
If you have proptosis, midface is unlikely to help. Imagine a belt on a big belly; that belt will slip down! The same thing for the lower eyelid in relation to the eye. Orbital decompression is a better answer. Also, note that the dry eyes will get worse with age.
fat grafting when done correctly may very well help the dry eye indeed.
lulu71 proptosis and under eye hollowJuly 23, 2011 11:31 AM
I have now added a photo. i have quite high cheek bones and what appears to have happened over the last few years is that the fat pad either from the cheek bone or just under the eye has slipped downwards. This makes the proptosis look even worse by leaving a hollow and the cheek bulging underneath. I have no loss of fat or aging elsewhere on the face and no drooping, its just the cheek...in fact I'm not even sure if its the cheek pad or fat from under the eye thats slipped down creating what looks like a bulging cheek. I don't really understand it as I have real aging, drooping or fat loss elsewhere on the face. Perhaps proptosis can somehow dispalce under eye fat :/
I would favour the safer option of fat transfer, but feel because of this sagging fat, if the whole hollow area is filled, because the concave part is so considerable, I am going to end up with very strange looking face and wondered if it would be sensible to somehow lift this opad of fat that has drooped down. many thanks for any nice advice!
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