Thyroid Eye Disease

  • Before-This patient presented with severe thyroid eye disease and experienced profound eye bulging, redness, orbital pain and light sensitivity.  She also sleeps with her eyes open but did not have double vision. The patient and Dr. Douglas customized a plan to include bilateral lateral and fat decompression to move the eyes back and reduce the white under her eyes.  She achieved the goal of a 7mm reduction and did not require additional surgery.  She did not experience any double vision or require other interventions.
    After-This patient presented with severe thyroid eye disease and experienced profound eye bulging, redness, orbital pain and light sensitivity.  She also sleeps with her eyes open but did not have double vision. The patient and Dr. Douglas customized a plan to include bilateral lateral and fat decompression to move the eyes back and reduce the white under her eyes.  She achieved the goal of a 7mm reduction and did not require additional surgery.  She did not experience any double vision or require other interventions.
    BeforeAfter
    This patient presented with severe thyroid eye disease and experienced profound eye bulging, redness, orbital pain and light sensitivity. She also sleeps with her eyes open but did not have double vision. The patient and Dr. Douglas customized a plan to include bilateral lateral and fat decompression to move the eyes back and reduce the white under her eyes. She achieved the goal of a 7mm reduction and did not require additional surgery. She did not experience any double vision or require other interventions.
  • Before-This patient with mild thyroid eye disease elected not to have any surgery.  She underwent a camouflage procedure using restylane to the cheek area to smooth the cheek contour and provide a youthful result while reversing the signs of thyroid eye disease.
    After-This patient with mild thyroid eye disease elected not to have any surgery.  She underwent a camouflage procedure using restylane to the cheek area to smooth the cheek contour and provide a youthful result while reversing the signs of thyroid eye disease.
    BeforeAfter
    This patient with mild thyroid eye disease elected not to have any surgery. She underwent a camouflage procedure using restylane to the cheek area to smooth the cheek contour and provide a youthful result while reversing the signs of thyroid eye disease.
  • Before-This patient with mild thyroid eye disease elected not to have any surgery.  She underwent a camouflage procedure using restylane to the cheek area to smooth the cheek contour and provide a youthful result while reversing the signs of thyroid eye disease.
    After-This patient with mild thyroid eye disease elected not to have any surgery.  She underwent a camouflage procedure using restylane to the cheek area to smooth the cheek contour and provide a youthful result while reversing the signs of thyroid eye disease.
    BeforeAfter
    This patient with mild thyroid eye disease elected not to have any surgery. She underwent a camouflage procedure using restylane to the cheek area to smooth the cheek contour and provide a youthful result while reversing the signs of thyroid eye disease.
  • Before-This patient with mild thyroid eye disease elected not to have any surgery.  She underwent a camouflage procedure using restylane to the cheek area to smooth the cheek contour and provide a youthful result while reversing the signs of thyroid eye disease.
    After-This patient with mild thyroid eye disease elected not to have any surgery.  She underwent a camouflage procedure using restylane to the cheek area to smooth the cheek contour and provide a youthful result while reversing the signs of thyroid eye disease.
    BeforeAfter
    This patient with mild thyroid eye disease elected not to have any surgery. She underwent a camouflage procedure using restylane to the cheek area to smooth the cheek contour and provide a youthful result while reversing the signs of thyroid eye disease.
  • Before-A very active 45 year old presented with severe thyroid eye disease accompanied by eye bulging, double vision, inability to close eyes during sleep and orbital ache /pain.  She was formerly very active (biking, running) but had to give up those activities due to double vision and pain.  She underwent bilateral customized medial lateral and fat decompressions, achieving a symmetric result and 7mm reduction in proptosis.  She underwent strabismus surgery, but no eyelid or revision surgery was required.  She subsequently completed her first triathlon.
    After-A very active 45 year old presented with severe thyroid eye disease accompanied by eye bulging, double vision, inability to close eyes during sleep and orbital ache /pain.  She was formerly very active (biking, running) but had to give up those activities due to double vision and pain.  She underwent bilateral customized medial lateral and fat decompressions, achieving a symmetric result and 7mm reduction in proptosis.  She underwent strabismus surgery, but no eyelid or revision surgery was required.  She subsequently completed her first triathlon.
    BeforeAfter
    A very active 45 year old presented with severe thyroid eye disease accompanied by eye bulging, double vision, inability to close eyes during sleep and orbital ache /pain. She was formerly very active (biking, running) but had to give up those activities due to double vision and pain. She underwent bilateral customized medial lateral and fat decompressions, achieving a symmetric result and 7mm reduction in proptosis. She underwent strabismus surgery, but no eyelid or revision surgery was required. She subsequently completed her first triathlon.
  • Before-A very active 45 year old presented with severe thyroid eye disease accompanied by eye bulging, double vision, inability to close eyes during sleep and orbital ache /pain.  She was formerly very active (biking, running) but had to give up those activities due to double vision and pain.  She underwent bilateral customized medial lateral and fat decompressions, achieving a symmetric result and 7mm reduction in proptosis.  She underwent strabismus surgery, but no eyelid or revision surgery was required.  She subsequently completed her first triathlon.
    After-A very active 45 year old presented with severe thyroid eye disease accompanied by eye bulging, double vision, inability to close eyes during sleep and orbital ache /pain.  She was formerly very active (biking, running) but had to give up those activities due to double vision and pain.  She underwent bilateral customized medial lateral and fat decompressions, achieving a symmetric result and 7mm reduction in proptosis.  She underwent strabismus surgery, but no eyelid or revision surgery was required.  She subsequently completed her first triathlon.
    BeforeAfter
    A very active 45 year old presented with severe thyroid eye disease accompanied by eye bulging, double vision, inability to close eyes during sleep and orbital ache /pain. She was formerly very active (biking, running) but had to give up those activities due to double vision and pain. She underwent bilateral customized medial lateral and fat decompressions, achieving a symmetric result and 7mm reduction in proptosis. She underwent strabismus surgery, but no eyelid or revision surgery was required. She subsequently completed her first triathlon.
  • Before-A very active 45 year old presented with severe thyroid eye disease accompanied by eye bulging, double vision, inability to close eyes during sleep and orbital ache /pain.  She was formerly very active (biking, running) but had to give up those activities due to double vision and pain.  She underwent bilateral customized medial lateral and fat decompressions, achieving a symmetric result and 7mm reduction in proptosis.  She underwent strabismus surgery, but no eyelid or revision surgery was required.  She subsequently completed her first triathlon.
    After-A very active 45 year old presented with severe thyroid eye disease accompanied by eye bulging, double vision, inability to close eyes during sleep and orbital ache /pain.  She was formerly very active (biking, running) but had to give up those activities due to double vision and pain.  She underwent bilateral customized medial lateral and fat decompressions, achieving a symmetric result and 7mm reduction in proptosis.  She underwent strabismus surgery, but no eyelid or revision surgery was required.  She subsequently completed her first triathlon.
    BeforeAfter
    A very active 45 year old presented with severe thyroid eye disease accompanied by eye bulging, double vision, inability to close eyes during sleep and orbital ache /pain. She was formerly very active (biking, running) but had to give up those activities due to double vision and pain. She underwent bilateral customized medial lateral and fat decompressions, achieving a symmetric result and 7mm reduction in proptosis. She underwent strabismus surgery, but no eyelid or revision surgery was required. She subsequently completed her first triathlon.
  • Before-This patient came with thyroid eye disease and moderate increase in eye bulging but she was most bothered by orbital pain and bilateral ache.  Dr. Douglas performed a novel and customized fat decompression to reduce orbital pain and eye bulging.  She achieved a 3mm reduction in proptosis requiring monitored anesthesia for approximately one hour with no overnight stay.  No revisions or eyelid surgery were needed.  The surgery completely relieved her orbital pain.
    After-This patient came with thyroid eye disease and moderate increase in eye bulging but she was most bothered by orbital pain and bilateral ache.  Dr. Douglas performed a novel and customized fat decompression to reduce orbital pain and eye bulging.  She achieved a 3mm reduction in proptosis requiring monitored anesthesia for approximately one hour with no overnight stay.  No revisions or eyelid surgery were needed.  The surgery completely relieved her orbital pain.
    BeforeAfter
    This patient came with thyroid eye disease and moderate increase in eye bulging but she was most bothered by orbital pain and bilateral ache. Dr. Douglas performed a novel and customized fat decompression to reduce orbital pain and eye bulging. She achieved a 3mm reduction in proptosis requiring monitored anesthesia for approximately one hour with no overnight stay. No revisions or eyelid surgery were needed. The surgery completely relieved her orbital pain.
  • Before-This patient presented, after five surgeries with an outside doctor, for thyroid eye disease. However, he still had severe eye prominence, eye redness, orbital pain, double vision and cannot enjoy outdoor activities. The previous surgeries unfortunately caused substantial scarring and eyelid paralysis. Dr. Douglas performed a customized decompression followed by strabismus surgery and eyelid reconstruction. He is now able to enjoy his activities and achieved a 5mm reduction in proptosis.
    After-This patient presented, after five surgeries with an outside doctor, for thyroid eye disease. However, he still had severe eye prominence, eye redness, orbital pain, double vision and cannot enjoy outdoor activities. The previous surgeries unfortunately caused substantial scarring and eyelid paralysis. Dr. Douglas performed a customized decompression followed by strabismus surgery and eyelid reconstruction. He is now able to enjoy his activities and achieved a 5mm reduction in proptosis.
    BeforeAfter
    This patient presented, after five surgeries with an outside doctor, for thyroid eye disease. However, he still had severe eye prominence, eye redness, orbital pain, double vision and cannot enjoy outdoor activities. The previous surgeries unfortunately caused substantial scarring and eyelid paralysis. Dr. Douglas performed a customized decompression followed by strabismus surgery and eyelid reconstruction. He is now able to enjoy his activities and achieved a 5mm reduction in proptosis.
  • Before-This patient presented, after five surgeries with an outside doctor, for thyroid eye disease. However, he still had severe eye prominence, eye redness, orbital pain, double vision and cannot enjoy outdoor activities. The previous surgeries unfortunately caused substantial scarring and eyelid paralysis. Dr. Douglas performed a customized decompression followed by strabismus surgery and eyelid reconstruction. He is now able to enjoy his activities and achieved a 5mm reduction in proptosis.
    After-This patient presented, after five surgeries with an outside doctor, for thyroid eye disease. However, he still had severe eye prominence, eye redness, orbital pain, double vision and cannot enjoy outdoor activities. The previous surgeries unfortunately caused substantial scarring and eyelid paralysis. Dr. Douglas performed a customized decompression followed by strabismus surgery and eyelid reconstruction. He is now able to enjoy his activities and achieved a 5mm reduction in proptosis.
    BeforeAfter
    This patient presented, after five surgeries with an outside doctor, for thyroid eye disease. However, he still had severe eye prominence, eye redness, orbital pain, double vision and cannot enjoy outdoor activities. The previous surgeries unfortunately caused substantial scarring and eyelid paralysis. Dr. Douglas performed a customized decompression followed by strabismus surgery and eyelid reconstruction. He is now able to enjoy his activities and achieved a 5mm reduction in proptosis.
  • Before-This patient presented with moderate thyroid eye disease with complaints of eye bulging, redness and orbital pain. A customized lateral and fat decompression without skin incision was chosen. She achieved a 4mm reduction in proptosis and required no strabismus surgery.
    After-This patient presented with moderate thyroid eye disease with complaints of eye bulging, redness and orbital pain. A customized lateral and fat decompression without skin incision was chosen. She achieved a 4mm reduction in proptosis and required no strabismus surgery.
    BeforeAfter
    This patient presented with moderate thyroid eye disease with complaints of eye bulging, redness and orbital pain. A customized lateral and fat decompression without skin incision was chosen. She achieved a 4mm reduction in proptosis and required no strabismus surgery.
  • Before-This patient presented with moderate thyroid eye disease and proptosis but was profoundly bothered by pain and eye irritation. A customized plan included closure of the tear punctum and selective bilateral decompression. No additional eyelid or strabismus surgery was required.
    After-This patient presented with moderate thyroid eye disease and proptosis but was profoundly bothered by pain and eye irritation. A customized plan included closure of the tear punctum and selective bilateral decompression. No additional eyelid or strabismus surgery was required.
    BeforeAfter
    This patient presented with moderate thyroid eye disease and proptosis but was profoundly bothered by pain and eye irritation. A customized plan included closure of the tear punctum and selective bilateral decompression. No additional eyelid or strabismus surgery was required.
  • Before-This patient presented with moderate thyroid eye disease and proptosis but was profoundly bothered by pain and eye irritation. A customized plan included closure of the tear punctum and selective bilateral decompression. No additional eyelid or strabismus surgery was required.
    After-This patient presented with moderate thyroid eye disease and proptosis but was profoundly bothered by pain and eye irritation. A customized plan included closure of the tear punctum and selective bilateral decompression. No additional eyelid or strabismus surgery was required.
    BeforeAfter
    This patient presented with moderate thyroid eye disease and proptosis but was profoundly bothered by pain and eye irritation. A customized plan included closure of the tear punctum and selective bilateral decompression. No additional eyelid or strabismus surgery was required.
  • Before-This patient presented with moderate thyroid eye disease and proptosis but was profoundly bothered by pain and eye irritation. A customized plan included closure of the tear punctum and selective bilateral decompression. No additional eyelid or strabismus surgery was required.
    After-This patient presented with moderate thyroid eye disease and proptosis but was profoundly bothered by pain and eye irritation. A customized plan included closure of the tear punctum and selective bilateral decompression. No additional eyelid or strabismus surgery was required.
    BeforeAfter
    This patient presented with moderate thyroid eye disease and proptosis but was profoundly bothered by pain and eye irritation. A customized plan included closure of the tear punctum and selective bilateral decompression. No additional eyelid or strabismus surgery was required.
  • Before-This patient presented with severe thyroid eye disease with double vision and vision loss due to compressive optic neuropathy. Patient underwent a bilateral decompression to relieve optic nerve compression, which moved the eyes into a normal position. Subsequently, he underwent strabismus surgery. He regained normal vision and required no further revisions.
    After-This patient presented with severe thyroid eye disease with double vision and vision loss due to compressive optic neuropathy. Patient underwent a bilateral decompression to relieve optic nerve compression, which moved the eyes into a normal position. Subsequently, he underwent strabismus surgery. He regained normal vision and required no further revisions.
    BeforeAfter
    This patient presented with severe thyroid eye disease with double vision and vision loss due to compressive optic neuropathy. Patient underwent a bilateral decompression to relieve optic nerve compression, which moved the eyes into a normal position. Subsequently, he underwent strabismus surgery. He regained normal vision and required no further revisions.
  • Before-This young woman came in with eye bulging and irritation but no double vision.  Her goal was to return to her normal appearance and reduce the eye bulging and especially “reduce the white under eyes”. Dr. Douglas performed a customized lateral and fat decompression to reduce eye bulging and the scleral showing –“white under her eyes”- by focusing on a particular part of the orbital floor.  By focusing on bone removal in this location, eyelid surgery is often unnecessary.  She achieved a substantial 6mm reduction in proptosis and was thrilled with the outcome.  She opted to forgo any additional surgery given the results.
    After-This young woman came in with eye bulging and irritation but no double vision.  Her goal was to return to her normal appearance and reduce the eye bulging and especially “reduce the white under eyes”. Dr. Douglas performed a customized lateral and fat decompression to reduce eye bulging and the scleral showing –“white under her eyes”- by focusing on a particular part of the orbital floor.  By focusing on bone removal in this location, eyelid surgery is often unnecessary.  She achieved a substantial 6mm reduction in proptosis and was thrilled with the outcome.  She opted to forgo any additional surgery given the results.
    BeforeAfter
    This young woman came in with eye bulging and irritation but no double vision. Her goal was to return to her normal appearance and reduce the eye bulging and especially “reduce the white under eyes”. Dr. Douglas performed a customized lateral and fat decompression to reduce eye bulging and the scleral showing –“white under her eyes”- by focusing on a particular part of the orbital floor. By focusing on bone removal in this location, eyelid surgery is often unnecessary. She achieved a substantial 6mm reduction in proptosis and was thrilled with the outcome. She opted to forgo any additional surgery given the results.
  • Before-This patient presented with eye aching and tearing associated with her thyroid eye disease. She achieved a 6mm reduction following medial and lateral decompression of her right eye.
    After-This patient presented with eye aching and tearing associated with her thyroid eye disease. She achieved a 6mm reduction following medial and lateral decompression of her right eye.
    BeforeAfter
    This patient presented with eye aching and tearing associated with her thyroid eye disease. She achieved a 6mm reduction following medial and lateral decompression of her right eye.
  • Before-This patient was experiencing eye redness, discomfort and vision loss due to thyroid eye disease. She achieved the return of normal vision after a customized approach of decompression and strabismus surgeries.
    After-This patient was experiencing eye redness, discomfort and vision loss due to thyroid eye disease. She achieved the return of normal vision after a customized approach of decompression and strabismus surgeries.
    BeforeAfter
    This patient was experiencing eye redness, discomfort and vision loss due to thyroid eye disease. She achieved the return of normal vision after a customized approach of decompression and strabismus surgeries.
  • Before-This patient came to Dr. Douglas with severe thyroid eye disease. After decompression surgeries, he achieved 6mm proptosis reduction and returned to his normal appearance.
    After-This patient came to Dr. Douglas with severe thyroid eye disease. After decompression surgeries, he achieved 6mm proptosis reduction and returned to his normal appearance.
    BeforeAfter
    This patient came to Dr. Douglas with severe thyroid eye disease. After decompression surgeries, he achieved 6mm proptosis reduction and returned to his normal appearance.
  • Before-Prior to seeing Dr. Douglas, this patient underwent multiple surgeries without seeing significant improvements. Dr. Douglas reconstructed her orbits and achieved a 6mm reduction.
    After-Prior to seeing Dr. Douglas, this patient underwent multiple surgeries without seeing significant improvements. Dr. Douglas reconstructed her orbits and achieved a 6mm reduction.
    BeforeAfter
    Prior to seeing Dr. Douglas, this patient underwent multiple surgeries without seeing significant improvements. Dr. Douglas reconstructed her orbits and achieved a 6mm reduction.

Prominent Eyes and Eyelid Revision Surgery

  • Before-This patient had prominent eyes as a result of blepharoplasty surgery. Dr. Douglas elevated her eyelid to improve function and appearance.
    After-This patient had prominent eyes as a result of blepharoplasty surgery. Dr. Douglas elevated her eyelid to improve function and appearance.
    BeforeAfter
    This patient had prominent eyes as a result of blepharoplasty surgery. Dr. Douglas elevated her eyelid to improve function and appearance.
  • Before-This patient presented with proptosis and retracting of the eyelids. After multiple surgeries with Dr. Douglas, he moved the eyes back and did mid face augmentation to improve eyelid closure and appearance.
    After-This patient presented with proptosis and retracting of the eyelids. After multiple surgeries with Dr. Douglas, he moved the eyes back and did mid face augmentation to improve eyelid closure and appearance.
    BeforeAfter
    This patient presented with proptosis and retracting of the eyelids. After multiple surgeries with Dr. Douglas, he moved the eyes back and did mid face augmentation to improve eyelid closure and appearance.

Orbital Trauma

  • Before-This patient came in after losing the eye to trauma and previous surgery resulting in an exposed orbital implant, which caused drooping of the right upper eyelid. Dr. Douglas performed orbital surgery to replace the infected implant, and then performed upper eyelid surgery to restore symmetry in her appearance.
    After-This patient came in after losing the eye to trauma and previous surgery resulting in an exposed orbital implant, which caused drooping of the right upper eyelid. Dr. Douglas performed orbital surgery to replace the infected implant, and then performed upper eyelid surgery to restore symmetry in her appearance.
    BeforeAfter
    This patient came in after losing the eye to trauma and previous surgery resulting in an exposed orbital implant, which caused drooping of the right upper eyelid. Dr. Douglas performed orbital surgery to replace the infected implant, and then performed upper eyelid surgery to restore symmetry in her appearance.
  • Before-The year previous, this patient experienced extensive orbital trauma. He was thrilled with the results after reconstruction of the orbit and midface.
    After-The year previous, this patient experienced extensive orbital trauma. He was thrilled with the results after reconstruction of the orbit and midface.
    BeforeAfter
    The year previous, this patient experienced extensive orbital trauma. He was thrilled with the results after reconstruction of the orbit and midface.

Cancer Surgery

  • Before-Patient demonstrates large defect from skin cancer removal which included the eyelid and cheek totaling 7cm in diameter.  Reconstruction was undertaken and included a skin graft to the lower eyelid and flap of the cheek.  Importantly, the patient was treated with four sessions of customized anti-scarring treatment to expand the tissue and dissolve the scarring.  Patient is shown approximately 9 months after original cancer reaction. No surgical revisions were needed.
    After-Patient demonstrates large defect from skin cancer removal which included the eyelid and cheek totaling 7cm in diameter.  Reconstruction was undertaken and included a skin graft to the lower eyelid and flap of the cheek.  Importantly, the patient was treated with four sessions of customized anti-scarring treatment to expand the tissue and dissolve the scarring.  Patient is shown approximately 9 months after original cancer reaction. No surgical revisions were needed.
    BeforeAfter
    Patient demonstrates large defect from skin cancer removal which included the eyelid and cheek totaling 7cm in diameter. Reconstruction was undertaken and included a skin graft to the lower eyelid and flap of the cheek. Importantly, the patient was treated with four sessions of customized anti-scarring treatment to expand the tissue and dissolve the scarring. Patient is shown approximately 9 months after original cancer reaction. No surgical revisions were needed.
  • Before-This patient underwent a radical excision of recurrent Melanoma and reconstruction of her left lower lid, nasal side wall, and cheek.
    After-This patient underwent a radical excision of recurrent Melanoma and reconstruction of her left lower lid, nasal side wall, and cheek.
    BeforeAfter
    This patient underwent a radical excision of recurrent Melanoma and reconstruction of her left lower lid, nasal side wall, and cheek.
  • Before-This patient presented with recurrent melanoma on the left side of his face. He underwent Mohs surgery and upper eyelid reconstruction; this was followed by scar therapy done using 5FU injections.
    After-This patient presented with recurrent melanoma on the left side of his face. He underwent Mohs surgery and upper eyelid reconstruction; this was followed by scar therapy done using 5FU injections.
    BeforeAfter
    This patient presented with recurrent melanoma on the left side of his face. He underwent Mohs surgery and upper eyelid reconstruction; this was followed by scar therapy done using 5FU injections.