Facial plast Surg 2015; 31(06): 633-644
DOI: 10.1055/s-0035-1568136
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Aesthetic Refinements in Patients with Prominent Eyes

Dirk F. Richter
Department for Plastic Surgery, Dreifaltigkeits-Hospital, Wesseling, Deutschland, Germany
Nina Schwaiger
Department for Plastic Surgery, Dreifaltigkeits-Hospital, Wesseling, Deutschland, Germany
Maria Wiedner
Department for Plastic and Reconstructive Surgery, University Clinic Graz, Graz, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
14 December 2015 (online)


The treatment of prominent eyes is still a challenging task. As well as the surgery, proper preoperative diagnosis differentiating between patients with and without Graves ophthalmopathy plays an important role. In functionally asymptomatic patients with Graves disease suffering from the aesthetic impairment of prominent eyes, the transpalpebral decompression by intraorbital fat removal technique has been proved to be reliable, effective, safe, and easily performed by a trained and experienced oculoplastic surgeon. This technique provides long-lasting results, leading to improvement not only in visual function but also in personal well-being and in the patient's social life, with a high benefit-to-risk ratio. The most powerful tool to treat the lower lid deformity and malar bags in patients without Graves disease is the subperiosteal midface lift. It shortens the lid–cheek junction and blends the retaining periorbital ligaments. Furthermore, it adds volume to the lower lid and gives a stable support. By the nature of the procedure, it also turns a negative into a positive vector. In experienced hands, Olivari's orbital decompression and Hester's midface lift are ideal options for the treatment of prominent eyes.