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Thyroid Eye Disease Surgery

What Is Grave’s Disease?

Thyroid orbitopathy (also known as thyroid eye disease or Graves’ eye disease) is an autoimmune inflammatory condition. It is related to the thyroid gland, which affects the different structures within the orbit (eye socket). It is also related to surrounding tissues including the eye muscles, orbital fat, and eyelids. The thyroid gland is also usually affected but the timing and severity of the thyroid gland disease and orbital disease can vary greatly. A small percentage of patients in Los Angeles may have eyelid and orbital manifestations of the disorder without developing a thyroid abnormality. For individuals who are suffering from bugling eyes due to thyroid orbitopathy, Dr. Taban performs orbital decompression surgery, a treatment that helps reduce the appearance of bulgy eyes by expanding the eye socket.

Orbital Decompression Surgery for Graves Disease

Symptoms Of Thyroid Eye Disease

As stated earlier, the eye/orbit involvement in Graves’ disease can range from very mild to very severe. The symptoms begin slowly but they can develop rapidly. The usual course of the eye disease is worsening over a year period, with subsequent “burning out.” It’s during the “burned out” stage that rehabilitative surgery (bulgy or bulging eye surgery through orbital decompression and blepharoplasty) in Los Angeles is usually performed.

Symptoms and signs also vary, depending on the severity of the disease. These include eye irritation/dryness, eye pressure, tearing, redness, eyelid swelling and retraction, bulgy or protruded eyes (proptosis), double vision (diplopia) and blurred or even loss of vision. The vision loss can be significant eye dryness or exposure (secondary to bulgy eyes – proptosis) and/or from optic nerve compression.

What Causes Bulging Eyes and it's Treatment - TabanMD, Beverly Hills, Los Angeles, Santa Barbara

Treatment For Grave’s Disease

The treatment of a patient with Graves’ disease is multidisciplinary, with help of endocrinologist, thyroid surgeon, ophthalmologist, and oculoplastic surgeon. The underlying problem, which is the thyroid gland, needs to be treated, which may include medications, radioactive iodine, and/or thyroid surgery.

During the active inflammatory stage of Graves’ disease, the eye symptoms are treated conservatively, including aggressive eye lubrication and possibly systemic medication (steroids). Smoking has been shown to worsen the eye pathology and hence quitting is highly recommended. Frequent monitoring may be necessary, especially in severe cases with significant bulgy eyes and risk of optic nerve damage.

Read Dr. Taban’s Manuscript about Modified (Scarless) Orbital Decompression Technique.

Modified (Scarless) Orbital Decompression Technique Before Image
Modified (Scarless) Orbital Decompression Technique After Image

Read Dr. Taban's manuscript about Expanding Role of Orbital Decompression in Aesthetic Surgery.

Cosmetic Orbital Decompression Surgery Before Image
Cosmetic Orbital Decompression Surgery After Image

Read Dr. Taban's Manuscript about Combined Orbital Decompression and Eyelid Retraction Surgery.

Orbital Decompression and Eyelid Retraction Surgery Before and After Images

Orbital Decompression Surgery For Thyroid Eye Disorders

Once the inflammatory phase of the disease has subsided, patients with eyelid abnormalities, double-vision or proptosis may be eligible for surgical correction to improve their function and appearance. The first stage of therapy is usually orbital decompression surgery (bulgy eye surgery) to reduce proptosis (protruded bulgy eyes) by expanding the eye socket (orbit) to allow the eyeball to move back.

Los Angeles Orbital Decompression Surgery
Scarless orbital decompression technique

Surgical video demonstrating scarless orbital decompression.

Intraoperative photo showing immediately after scarless left orbital decompression surgery, contrasted with yet untreated bulging right eye.

Oculoplastic Surgeon Dr. Taban in Los Angeles uses the latest minimally invasive technique, through hidden incisions, to achieve the desired effect. By making the orbit larger internally, the eyeball can sit back more into a more natural state, reducing or eliminating the appearance of bulging eyes.This is an outpatient surgery procedure with about 7-10 days of postoperative swelling/bruising. Second stage surgery is for those with restrictive strabismus causing diplopia (double vision) not corrected by prism glasses. The third stage operation is eyelid surgery, both reconstructive and cosmetic. Eyelid retraction is a frequent abnormality of thyroid eye disease causing elevation of the upper eyelids, giving a “stared” look appearance. This can be corrected, along with bags around the eyes.

During your consultation with Dr. Taban in Beverly Hills or Los Angeles, he will evaluate your eyes and orbits to assess your specific anatomy and severity of  Graves’ disease, including proptosis (bulgy eye) and eyelid retraction, and then discuss the different treatments necessary, including orbital decompression surgery (bulgy eye surgery), retraction surgery, and/or blepharoplasty. Sometimes, noninvasive surgery using injectable fillers can improve eye appearance, by improving retraction and/or hollowness around the eyes. The goal of the treatment is to restore natural youthfulness to the eyes and surrounding structures.

Young beautiful woman with severe Grave thyroid eye disease traveled from Slovakia to Los Angeles and underwent life-changing treatment including scarless orbital decompression surgery, lower eyelid retraction surgery, and upper blepharoplasty, to restore more natural eye shape and function. Before and 3 months after surgery results are shown.
Young beautiful woman with severe Grave thyroid eye disease traveled from Slovakia to Los Angeles and underwent life-changing treatment including scarless orbital decompression surgery, lower eyelid retraction surgery, and upper blepharoplasty, to restore more natural eye shape and function. Before and 3 months after surgery results are shown.
Orbital Decompression Surgery Los Angeles, Beverly Hills
Young woman, who traveled from Sweden to Beverly Hills CA to undergo orbital decompression surgery for bulging eyes.
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Young mother, with Graves thyroid eye disease, underwent combination of orbital decompression surgery (for bulging eyes) and lower eyelid retraction surgery with orbital rim onlay implant.
Orbital Decompression, Eyelid retraction Surgery for Graves Eye Disease
Young mother, with Graves thyroid eye disease, underwent combination of orbital decompression surgery (for bulging eyes) and lower eyelid retraction surgery with orbital rim onlay implant.
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This video depicts an unfortunate man from Canada with thyroid eye disease who had incorrect procedures. Instead of orbital decompression and lower eyelid retraction surgery to correct bulging eyes, he had disfiguring lateral tarsorrhaphy where the corners of the eyes are pinched closed which also limits the side vision. He also has untreated upper eyelid retraction. He wanted to share his story to educate other patients about what not to do and what should be done.
Thyroid Orbital Decompression -- Dr. Mehryar Taban
To better understand your options for thyroid eye disease treatment, contact oculoplastic surgeon Dr. Taban to schedule your initial consultation in our offices in greater Los Angeles area (Beverly Hills) for consideration of orbital decompression surgery costs, blepharoplasty, and/or injectable treatments.

Before & After Real Patient Photos

*See disclaimer below
Young beautiful woman with severe Grave thyroid eye disease traveled from Slovakia to Los Angeles and underwent life-changing treatment including scarless orbital decompression surgery, lower eyelid retraction surgery, and upper blepharoplasty, to restore more natural eye shape and function. Before and 3 months after surgery results are shown.
Middle age male, with thyroid eye disease, who underwent eye socket surgery followed later by lower eyelid retraction surgery and canthoplasty.
Before (left) and 3 months after (right photo) of right upper eyelid ptosis surgery, left upper eyelid retraction procedure and bilateral lower blepharoplasty.
36 year old female, with Graves Thyroid Eye Disease with proptosis (bulging eyes), underwent orbital decompression surgery. Before and 3 months after oculoplastic surgery photos are shown.
Before (left) and after (right) orbital decompression surgery
Before (left), 24 year old female, with severe bulgy eyes and lower eyelid retraction from Grave’s Disease, with significant change in eye appearance and function. After (right), 1 month after bilateral orbital decompression surgery and lower eyelid retraction surgery. Note improved eye appearance.
34 year old female, with bulging eyes from Graves disease, underwent combined orbital decompression surgery plus lower eyelid retraction surgery plus orbital rim (tear trough) implant placement. Before and 6 weeks after surgery results are shown. You can see her video testimonial on our website testimonial page and her surgical video on specified procedures
18 year old female teenager, with rare childhood Graves disease resulting in bulging eyes and change in eye shape, underwent orbital decompression surgery and lower eyelid retraction surgery. Before and 2 months after surgery results are shown. You can find her video testimonial on our website testimonial page.
59 year old male, with bulging eyes due to Graves thyroid eye disease, underwent scarless orbital decompression surgery. Before and 3 months after surgery photos are shown.
38 year old Asian female, with severe bulging eyes due to Graves thyroid eye disease, along with lower eyelid retraction with scleral show. She underwent combined orbital decompression surgery and lower eyelid retraction surgery. Before and 6 weeks after transforming eye plastic surgery photos are shown.
Before (left) and 3-months after (right) bilateral orbital decompression and upper eyelid retraction surgery.
Before (left). After (right) 38 year old female, with bulgy eyes from Graves thyroid disease who underwent bilateral orbital decompression surgery.
Orbital decompression page and gallery: Beautiful woman, affected by Graves thyroid eye disease causing bulging eyes and eye fat bags, underwent scarless orbital decompression and lower blepharoplasty. Note more natural and rested eye appearance in after photo 1 month after surgery.

Beautiful woman, with severe left eye changes due to Graves thyroid eye disease with inability to close her left eye, underwent scarless left orbital decompression and eyelid surgery

*Disclaimer: Results vary from patient to patient. Results are not guaranteed.