Cosmetic orbital decompression botch rates???

[Taylors_Lil_Ethnic]

So ive been considering likely getting orbital decompression in the next couple of years and ive looked into it and want your thoughts:https://pmc.ncbi.nlm.nih.gov/articl...rpalpebral distance, and intraocular pressure.
As you can see in the study done cosmetic orbitao decompression had nearly 0 botchs on 23 cases now im thinking is this the true average or is it missing sample size??? Any thoughts

 

[Taylors_Lil_Ethnic]

So ive been considering likely getting orbital decompression in the next couple of years and ive looked into it and want your thoughts:https://pmc.ncbi.nlm.nih.gov/articles/PMC12551737/#:~:text=The mean volume of resected,interpalpebral distance, and intraocular pressure.
As you can see in the study done cosmetic orbitao decompression had nearly 0 botchs on 23 cases now im thinking is this the true average or is it missing sample size??? Any thoughts

Bump

 

[Taylors_Lil_Ethnic]

So ive been considering likely getting orbital decompression in the next couple of years and ive looked into it and want your thoughts:https://pmc.ncbi.nlm.nih.gov/articles/PMC12551737/#:~:text=The mean volume of resected,interpalpebral distance, and intraocular pressure.
As you can see in the study done cosmetic orbitao decompression had nearly 0 botchs on 23 cases now im thinking is this the true average or is it missing sample size??? Any thoughts

Bump

 

[Taylors_Lil_Ethnic]

So ive been considering likely getting orbital decompression in the next couple of years and ive looked into it and want your thoughts:https://pmc.ncbi.nlm.nih.gov/articles/PMC12551737/#:~:text=The mean volume of resected,interpalpebral distance, and intraocular pressure.
As you can see in the study done cosmetic orbitao decompression had nearly 0 botchs on 23 cases now im thinking is this the true average or is it missing sample size??? Any thoughts

Niggas skip any thread on self improvement bro, org is in shambles

 

[bossman]

The top OD surgeons regularly perform cosmetic surgeries and have 0% complication rates on non-syndromic patients, when only the lateral wall ± fat is involved.

 

[xaxanibber]

Niggas skip any thread on self improvement bro, org is in shambles

the average attention span of the site needs to be tested

 

[Nahorscend]

The main risk is double vision. The risk for this is near 0% for cosmetic cases.

It needs to be lateral wall and/or fat, not medial wall which is much riskier. If you have heard of the famous frank tufano botch, it happened because he did both lateral and medial instead of lateral only.

Also it needs to be performed by an elite surgeon who specialises in cosmetic decompression and does a large volume of decompressions a year, of which there are just a handful on the planet. Every surgeon has their personal rates of incidence which you need to check with them. Some may be so skilled that they can get a safe rate even with other walls.

But basically as long as you go with an elite surgeon and do lateral/fat, the top end of the range I'm aware of is 3% (for fat decompressions in Japan). If you go to the US for lateral (+ fat), it is 0% if you are not diseased and don't need a big movement.

You can always be the spectacularly unlucky one but the risk % is not higher than risks of severe complications in various other surgeries. Also, in the worst case if you do get double vision there is a second surgery you can do to correct it.

 

[Foreverbrad]

Anyone know good surgeons for this outside the US? US prices are obviously unaffordable. I struggle to find ANYONE offering this for cosmetic reasons in Europe.

 

[BronzeSpartan2]

Anyone know good surgeons for this outside the US? US prices are obviously unaffordable. I struggle to find ANYONE offering this for cosmetic reasons in Europe.

Dr Marco Sales in Spain is a very good one but I'm not sure if he uses a deep lateral approach. The guy in the photo below was a Reddit user who went to a doctor called Dr Umit Beden and he got it for cosmetic purposes but his proptosis was TED-tier, he mentioned his Hertel measurement was like 23mm. He got a medial wall decompression though and 5-6mm reduction in proptosis I believe. Apparently, he also only paid 3k which is insane considering US surgeons charge like 25k or more.

OD isn't a surgery I would cheap out on, the US surgeons charge their prices because they have the most experience and expertise. But your best bet would be going to Dr Marco Sales, he is a great surgeon that the other US surgeons also recommend. If you're extremely low inhib you could try going to Dr Umit Beden but just make sure whoever you go to you only do a single wall decompression (and be aware that medial wall approach can reduce IPD).

 

[Foreverbrad]

Dr Marco Sales in Spain is a very good one but I'm not sure if he uses a deep lateral approach. The guy in the photo below was a Reddit user who went to a doctor called Dr Umit Beden and he got it for cosmetic purposes but his proptosis was TED-tier, he mentioned his Hertel measurement was like 23mm. He got a medial wall decompression though and 5-6mm reduction in proptosis I believe. Apparently, he also only paid 3k which is insane considering US surgeons charge like 25k or more.

OD isn't a surgery I would cheap out on, the US surgeons charge their prices because they have the most experience and expertise. But your best bet would be going to Dr Marco Sales, he is a great surgeon that the other US surgeons also recommend. If you're extremely low inhib you could try going to Dr Umit Beden but just make sure whoever you go to you only do a single wall decompression (and be aware that medial wall approach can reduce IPD).

It’s my final solution if periorbital grafts don’t work, I’m not fucking around with implants and all that. Would help my ESR a little too by raising IPD slightly. I don’t need much at the moment, maybe 3mm proptosis reduction. I have a sneaky suspicion my eyes will bug out even more though as I age because of genetic problems.

I’ll keep a note of these names. I think given the nature of the surgery there is not really an “aesthetic” component to it and any surgeon who has plenty of experience and good results with this surgery should be able to offer a lateral wall decompression.

 

[Nahorscend]

Anyone know good surgeons for this outside the US? US prices are obviously unaffordable. I struggle to find ANYONE offering this for cosmetic reasons in Europe.

Bernardini will do it for cosmetic reasons and is probably the best option in Europe but will cost much more than many US options except ones like Taban. Otherwise yes look to Spain as mentioned above.

It’s my final solution if periorbital grafts don’t work, I’m not fucking around with implants and all that. Would help my ESR a little too by raising IPD slightly. I don’t need much at the moment, maybe 3mm proptosis reduction. I have a sneaky suspicion my eyes will bug out even more though as I age because of genetic problems.

I’ll keep a note of these names. I think given the nature of the surgery there is not really an “aesthetic” component to it and any surgeon who has plenty of experience and good results with this surgery should be able to offer a lateral wall decompression.

OD will not increase your IPD, it will only decrease it, either significantly (medial) or negligibly (lateral). Most likely you will just maintain the same IPD.

Also if you have proptosis there is a decent chance you also do need implants for a good result. But not guaranteed that you will, and also surgeons will differ on whether they like implants or wish to avoid them.

 

[bossman]

Dr Marco Sales in Spain is a very good one but I'm not sure if he uses a deep lateral approach. The guy in the photo below was a Reddit user who went to a doctor called Dr Umit Beden and he got it for cosmetic purposes but his proptosis was TED-tier, he mentioned his Hertel measurement was like 23mm. He got a medial wall decompression though and 5-6mm reduction in proptosis I believe. Apparently, he also only paid 3k which is insane considering US surgeons charge like 25k or more.

OD isn't a surgery I would cheap out on, the US surgeons charge their prices because they have the most experience and expertise. But your best bet would be going to Dr Marco Sales, he is a great surgeon that the other US surgeons also recommend. If you're extremely low inhib you could try going to Dr Umit Beden but just make sure whoever you go to you only do a single wall decompression (and be aware that medial wall approach can reduce IPD).

Umit Beden flat out told me 30% double vision rate even in non-syndromic patients. So I guess he’s an honest doctor, but with horrendous complication statistics.

OD will not increase your IPD, it will only decrease it, either significantly (medial) or negligibly (lateral). Most likely you will just maintain the same IPD.

Lateral only has a good track record of increasing IPD. Which Douglas and some studies do mention. However it’s not worth consideration in my opinion.

 

[Nahorscend]

Lateral only has a good track record of increasing IPD. Which Douglas and some studies do mention. However it’s not worth consideration in my opinion.

From my knowledge only anterior lateral because it will induce sideways movement the way medial does, but not deep lateral because it induces only posterior movement for all intents and purposes.

 

[Taylors_Lil_Ethnic]

The top OD surgeons regularly perform cosmetic surgeries and have 0% complication rates on non-syndromic patients, when only the lateral wall ± fat is involved.

Plsss can you give me mentions of your sources,im very interested

 

[Taylors_Lil_Ethnic]

Dr Marco Sales in Spain is a very good one but I'm not sure if he uses a deep lateral approach. The guy in the photo below was a Reddit user who went to a doctor called Dr Umit Beden and he got it for cosmetic purposes but his proptosis was TED-tier, he mentioned his Hertel measurement was like 23mm. He got a medial wall decompression though and 5-6mm reduction in proptosis I believe. Apparently, he also only paid 3k which is insane considering US surgeons charge like 25k or more.

OD isn't a surgery I would cheap out on, the US surgeons charge their prices because they have the most experience and expertise. But your best bet would be going to Dr Marco Sales, he is a great surgeon that the other US surgeons also recommend. If you're extremely low inhib you could try going to Dr Umit Beden but just make sure whoever you go to you only do a single wall decompression (and be aware that medial wall approach can reduce IPD).

Mirin the ascension, and you are right higher pricing usually equals higher and better results other than that mf Dr.taban

 

[bossman]

Mirin the ascension, and you are right higher pricing usually equals higher and better results other than that mf Dr.taban

jfl 0 iq - taban is probably the most expensive of them all

 

[Taylors_Lil_Ethnic]

Lateral only has a good track record of increasing IPD. Which Douglas and some studies do mention. However it’s not worth consideration in my opinion.

Holy shit i have close set eyes due to my veryyy deep medial canthus and i wouldnt mind a couple mms of spacing so i can get to ideal range but what about upper like the roof?

 

[Taylors_Lil_Ethnic]

jfl 0 iq - taban is probably the most expensive of them all

I said except him, but i wouldnt blame him for what happened to frank truffano. Franks known for making the absolute worst choices ever in all his career. He wants to go the cheap way thats why he accepted the 10k discount from taban to do all 3 wall thinning and more focused on the inner medial wall that botched him, NEVER GO CHEAP FOR YOUR EYES

 

[BronzeSpartan2]

I said except him, but i wouldnt blame him for what happened to frank truffano. Franks known for making the absolute worst choices ever in all his career. He wants to go the cheap way thats why he accepted the 10k discount from taban to do all 3 wall thinning and more focused on the inner medial wall that botched him, NEVER GO CHEAP FOR YOUR EYES

Bro Taban upcharged Frank 10k to do the medial wall, he didn’t go cheap, he paid extra…

 

[Taylors_Lil_Ethnic]

The main risk is double vision. The risk for this is near 0% for cosmetic cases.

It needs to be lateral wall and/or fat, not medial wall which is much riskier. If you have heard of the famous frank tufano botch, it happened because he did both lateral and medial instead of lateral only.

Also it needs to be performed by an elite surgeon who specialises in cosmetic decompression and does a large volume of decompressions a year, of which there are just a handful on the planet. Every surgeon has their personal rates of incidence which you need to check with them. Some may be so skilled that they can get a safe rate even with other walls.

But basically as long as you go with an elite surgeon and do lateral/fat, the top end of the range I'm aware of is 3% (for fat decompressions in Japan). If you go to the US for lateral (+ fat), it is 0% if you are not diseased and don't need a big movement.

You can always be the spectacularly unlucky one but the risk % is not higher than risks of severe complications in various other surgeries. Also, in the worst case if you do get double vision there is a second surgery you can do to correct it.

I do NOT think the severe complication from this is double vision bro,its highly likely permanent blindness

 

[Nahorscend]

I do NOT think the severe complication from this is double vision bro,its highly likely permanent blindness

I mean technically yes, in the same way that the most severe complication from any surgery is death from general anaesthesia. If you want to consider 1 in 100k type risks, then sure. Blindness is also the most severe possible complication of bimax.

But if you want to be serious about it then it is extremely well-known that double vision is the primary risk. Every other reply in this thread is also referring to that btw. Or ask any surgeon and they will tell you this, and do your own research to understand this surgery. OD surgery technique is tailored and done with double vision in mind, the patient, the surgeon, and the staff all know going in that double vision is the thing you need to worry about.

Most decent surgeons will go their entire careers without a single case of blindness. But every single one of them will have cases of double vision and it's all about who has the lowest rates of incidence.

 

[BronzeSpartan2]

Umit Beden flat out told me 30% double vision rate even in non-syndromic patients. So I guess he’s an honest doctor, but with horrendous complication statistics.

Is that statistic referring to transient or permanent diplopia? The guy in the Reddit post had diplopia for a short while but it resolved by itself.

 

[BronzeSpartan2]

I’ll keep a note of these names. I think given the nature of the surgery there is not really an “aesthetic” component to it and any surgeon who has plenty of experience and good results with this surgery should be able to offer a lateral wall decompression.

The surgeons who do OD take different approaches to the surgery. Some specialise in lateral wall, like Raymond Douglas and Ramesh, and will only do other walls like medial in 1 or 2 patients out of like 100 decompression surgeries per year for those with bad Graves or very large eyeballs.

Other surgeons will specialise in other walls like the deep floor, Dr Vrcek is an example. As far as I am aware, they are unlikely to do lateral wall decompression as that is not their preferred approach. It may be worth asking the surgeon though. However, if the surgeon is skilled the complication rates are likely to be similar to that of the lateral wall.

Lateral wall decompression doesn’t necessarily lead to more aesthetic outcomes, it’s just reported to have far lower complication rates than the other walls in the literature, which is why people here recommend going to a surgeon who specialises in lateral wall for OD.

 

[Foreverbrad]

Lateral wall decompression doesn’t necessarily lead to more aesthetic outcomes, it’s just reported to have far lower complication rates than the other walls in the literature, which is why people here recommend going to a surgeon who specialises in lateral wall for OD.

I’ve seen in a study that lateral wall gives a very slight boost to IPD, somewhere around 1mm of IPD for typical 5mm reduction in proptosis. Whereas the medial wall was almost a 1:1 ratio which could be useful for dolphin cels but never for me.

 

[Taylors_Lil_Ethnic]

I mean technically yes, in the same way that the most severe complication from any surgery is death from general anaesthesia. If you want to consider 1 in 100k type risks, then sure. Blindness is also the most severe possible complication of bimax.

But if you want to be serious about it then it is extremely well-known that double vision is the primary risk. Every other reply in this thread is also referring to that btw. Or ask any surgeon and they will tell you this, and do your own research to understand this surgery. OD surgery technique is tailored and done with double vision in mind, the patient, the surgeon, and the staff all know going in that double vision is the thing you need to worry about.

Most decent surgeons will go their entire careers without a single case of blindness. But every single one of them will have cases of double vision and it's all about who has the lowest rates of incidence.

Holy mirin explanation dude, thx

 

[BronzeSpartan2]

I’ve seen in a study that lateral wall gives a very slight boost to IPD, somewhere around 1mm of IPD for typical 5mm reduction in proptosis. Whereas the medial wall was almost a 1:1 ratio which could be useful for dolphin cels but never for me.

Also, a Redditor who’s going to Dr Marco Sales in May told me it’s 14,000 Euros or £12k for decompression alone. He also does lateral wall decompression, but I don’t think that he’s much cheaper than US surgeons.

 

[ChadsAreCool]

Anyone know if dr deepak ramesh is one the elite surgeons in the US?

 

[bossman]

Also, a Redditor who’s going to Dr Marco Sales in May told me it’s 14,000 Euros or £12k for decompression alone. He also does lateral wall decompression, but I don’t think that he’s much cheaper than US surgeons.

It’s cheaper than someone like Douglas or Taban, but I think Ramesh edges out on cost.

I consulted Dr. Sales in person and was not confident in his abilities to proceed. He is a honest and humble man, and by far the most convenient option for me. But I don’t think he is as good as the Americans.

Anyone know if dr deepak ramesh is one the elite surgeons in the US?

He is clearly very knowledgable. But he does not have enough results so it’s hard to say for certain.

 

[Taylors_Lil_Ethnic]

Also, a Redditor who’s going to Dr Marco Sales in May told me it’s 14,000 Euros or £12k for decompression alone. He also does lateral wall decompression, but I don’t think that he’s much cheaper than US surgeons.

Will he post the results??

 

[BronzeSpartan2]

It’s cheaper than someone like Douglas or Taban, but I think Ramesh edges out on cost.

I consulted Dr. Sales in person and was not confident in his abilities to proceed. He is a honest and humble man, and by far the most convenient option for me. But I don’t think he is as good as the Americans.


He is clearly very knowledgable. But he does not have enough results so it’s hard to say for certain.

At least with Ramesh you know you’re in experienced hands when it comes the orbital decompression, which will in itself make most of the difference for bug eyecels like me.

 

[Firstname.Lastname]

Not even HA has 0% complication rates, theirs a reason I have this faggot on ignore.

 

[ChadsAreCool]

It’s cheaper than someone like Douglas or Taban, but I think Ramesh edges out on cost.

I consulted Dr. Sales in person and was not confident in his abilities to proceed. He is a honest and humble man, and by far the most convenient option for me. But I don’t think he is as good as the Americans.


He is clearly very knowledgable. But he does not have enough results so it’s hard to say for certain.

Really? Would you prefer douglas over ramesh?

 

[Nahorscend]

Really? Would you prefer douglas over ramesh?

Douglas is probably preferable over anyone else in the world for OD, but he is very expensive.

And he may not be preferable over everyone else for every other procedure you typically need in the eye area. If you had infinite money and time the ideal thing is probably to do OD with him and then other things elsewhere.

 

[Taylors_Lil_Ethnic]

Not even HA has 0% complication rates, theirs a reason I have this faggot on ignore.

Who tf said anything about 0%?? Are you mentally retarded?

 

[Firstname.Lastname]

Who tf said anything about 0%?? Are you mentally retarded?

Try learning to read English dirty nigger. Before you move the goal post(cuz your an 80iq who’s talking out of his ass), limiting the claim to some subgroup neither remediates the claim nor makes it true(it’s not).

I wasn’t even talking to you or about you. So get the cock outta your brains tard before you open that low iq mouth of yours. Hopefully you get botched.

 

[Taylors_Lil_Ethnic]

Try learning to read English dirty nigger. Before you move the goal post(cuz your an 80iq who’s talking out of his ass), limiting the claim to some subgroup neither remediates the claim nor makes it true(it’s not).

I wasn’t even talking to you or about you. So get the cock outta your brains tard before you open that low iq mouth of yours. Hopefully you get botched.

View attachment 4756472

Well guess what retard, you didnt respond to his post. You just sent the message herw

 

[ChadsAreCool]

Douglas is probably preferable over anyone else in the world for OD, but he is very expensive.

And he may not be preferable over everyone else for every other procedure you typically need in the eye area. If you had infinite money and time the ideal thing is probably to do OD with him and then other things elsewhere.

What makes Douglas more favorable then Ramesh? I know they both learned from the same surgeon, has publications together, they both preform over 100 OD surgerys per year. Does douglas just have more time in and/or experience in cosmetic decompressions? Im asking this because Ramesh is legit 40 minutes away from me lol.

 

[Nahorscend]

What makes Douglas more favorable then Ramesh? I know they both learned from the same surgeon, has publications together, they both preform over 100 OD surgerys per year. Does douglas just have more time in and/or experience in cosmetic decompressions? Im asking this because Ramesh is legit 40 minutes away from me lol.

Douglas seems to be the most reputed figure worldwide for OD but the difference most likely isn't so high that you should go to Douglas if Ramesh is so close, plus you'd save a ton on costs.

The thing with Douglas is he has a philosophy of minimising the number of procedures needed and so he has a different OD technique that eliminates the need for lower lid retraction repair. Usually you just move the eye back then raise the lid up with an eyelid surgery to fix scleral show. Douglas can fix scleral show via the OD itself. But who knows, maybe this is not even a benefit if you want exact control over lid contour, I don't know.

 

[yussimania]

Try learning to read English dirty nigger. Before you move the goal post(cuz your an 80iq who’s talking out of his ass), limiting the claim to some subgroup neither remediates the claim nor makes it true(it’s not).

I wasn’t even talking to you or about you. So get the cock outta your brains tard before you open that low iq mouth of yours. Hopefully you get botched.

View attachment 4756472

You're a pretentious cunt

It's never that serious

 

[ChadsAreCool]

Douglas seems to be the most reputed figure worldwide for OD but the difference most likely isn't so high that you should go to Douglas if Ramesh is so close, plus you'd save a ton on costs.

The thing with Douglas is he has a philosophy of minimising the number of procedures needed and so he has a different OD technique that eliminates the need for lower lid retraction repair. Usually you just move the eye back then raise the lid up with an eyelid surgery to fix scleral show. Douglas can fix scleral show via the OD itself. But who knows, maybe this is not even a benefit if you want exact control over lid contour, I don't know.

Interesting. I was under the assumption that both Douglas and Ramesh uses the same technique (deep lateral wall). Maybe there are slight differences to that approach aswell. I wonder how many cosmetic cases of OD these surgeons preform. I've read on Ramesh's reddit posts/comments that he preforms cosmetic cases because the outcome is very predictable. He seems like a good guy.

 

[Nahorscend]

Interesting. I was under the assumption that both Douglas and Ramesh uses the same technique (deep lateral wall). Maybe there are slight differences to that approach aswell.

Douglas is likelier to split it up between deep lateral and fat

But that isn't the relevant difference here, it's the fact that Douglas additionally shaves the bottom corner to shift the eye down in addition to back, which is why you then don't need to also raise the lid up. He has some lectures on his yt explaining this. Typically you could get like 1-1.5 mm extra of scleral show reduction from the OD with this method.

He seems like a good guy.

Yes

 

[gnwitch]

I feel like Im playing russian roulette with each surgery I do, and i always weigh the risk vs benefits.. with that being said i wouldnt trust a sample size of 23 to risk my vision and having my life ruined lol. If you do somehow get botched ur getting 0 compensation also.

 

[Taylors_Lil_Ethnic]

Interesting. I was under the assumption that both Douglas and Ramesh uses the same technique (deep lateral wall). Maybe there are slight differences to that approach aswell. I wonder how many cosmetic cases of OD these surgeons preform. I've read on Ramesh's reddit posts/comments that he preforms cosmetic cases because the outcome is very predictable. He seems like a good guy.

Yo where do i see any data about ramesh and douglas?

 

[BronzeSpartan2]

Interesting. I was under the assumption that both Douglas and Ramesh uses the same technique (deep lateral wall). Maybe there are slight differences to that approach aswell. I wonder how many cosmetic cases of OD these surgeons preform. I've read on Ramesh's reddit posts/comments that he preforms cosmetic cases because the outcome is very predictable. He seems like a good guy.

Ramesh performs 40-50 cosmetic decompressions a year. Vrcek also performs a similar number of decompressions on non-TED patients (asked them both on Reddit/Insta).

 

[e369]

So ive been considering likely getting orbital decompression in the next couple of years and ive looked into it and want your thoughts:https://pmc.ncbi.nlm.nih.gov/articles/PMC12551737/#:~:text=The mean volume of resected,interpalpebral distance, and intraocular pressure.
As you can see in the study done cosmetic orbitao decompression had nearly 0 botchs on 23 cases now im thinking is this the true average or is it missing sample size??? Any thoughts

Dont do it. You have chance to go blind

 

[BronzeSpartan2]

I feel like Im playing russian roulette with each surgery I do, and i always weigh the risk vs benefits.. with that being said i wouldnt trust a sample size of 23 to risk my vision and having my life ruined lol. If you do somehow get botched ur getting 0 compensation also.

I mean TED itself is somewhat rare (the annual incidence is 16 per 100,000 women and 2.9 per 100,000 men in the United States), and not everyone who gets TED will get OD, it’s hard to get a large sample size for an orbital decompression study. OD for non-TED patients is a relatively new surgery hence there aren’t that many studies on it out there either.

The best we can do is look at this meta-analysis which encompasses 5102 patients. https://pubmed.ncbi.nlm.nih.gov/39696149/
Pooled complication rates are 3% for lateral and fat decompression approach. Obviously this statistic comes from TED patients, complication rates for non-TED patients will be lower due to inflammation and extraocular muscle enlargement in TED patients increasing the risk of double vision post-OD. So inferring a 0-1.5% risk of double vision sounds to be reasonable for cosmetic OD (assuming you get lateral wall only).

OD is pretty much the only way to make your eyes more deepset, so there’s no alternative. If you’re very concerned about the risk, I’d just save up the money and go to Dr Douglas, there’s no one better in the world for performing the procedure than him.

 

[BronzeSpartan2]

Dont do it. You have chance to go blind

Lmao, the probability of going blind is a lot less than 1 in 1000 for each eye. If you’re not willing to accept a minute risk like that you shouldn’t be considering surgery.

 

[ChadsAreCool]

I mean TED itself is somewhat rare (the annual incidence is 16 per 100,000 women and 2.9 per 100,000 men in the United States), and not everyone who gets TED will get OD, it’s hard to get a large sample size for an orbital decompression study. OD for non-TED patients is a relatively new surgery hence there aren’t that many studies on it out there either.

The best we can do is look at this meta-analysis which encompasses 5102 patients. https://pubmed.ncbi.nlm.nih.gov/39696149/
Pooled complication rates are 3% for lateral and fat decompression approach. Obviously this statistic comes from TED patients, complication rates for non-TED patients will be lower due to inflammation and extraocular muscle enlargement in TED patients increasing the risk of double vision post-OD. So inferring a 0-1.5% risk of double vision sounds to be reasonable for cosmetic OD (assuming you get lateral wall only).

OD is pretty much the only way to make your eyes more deepset, so there’s no alternative. If you’re very concerned about the risk, I’d just save up the money and go to Dr Douglas, there’s no one better in the world for performing the procedure than him.

Im planning to get OD from Dr. Ramesh as he is much closer to me. Do you think its worth the additional Hassle + Money to get the procedure from Dr. Douglas? What would you estimate their skill differences to be?

 

[svarddre]

Probably the worst ROI possible

 

[ChadsAreCool]

Douglas is likelier to split it up between deep lateral and fat

But that isn't the relevant difference here, it's the fact that Douglas additionally shaves the bottom corner to shift the eye down in addition to back, which is why you then don't need to also raise the lid up. He has some lectures on his yt explaining this. Typically you could get like 1-1.5 mm extra of scleral show reduction from the OD with this method.


If the protruding eye originally does not have scleral show, would this even be necessary?