Orbital Rim Contouring Through Upper Eyelid Incision

This patient underwent orbital rim contouring as part of facial feminization surgery.

If you would like to see additional before and after FFS photographs by Dr. Mittermiller, please click here:

FFS Before and After Photographs

Contouring of the orbital rims is most commonly performed through a coronal incision, which is an incision that goes over the top of the head from on ear to the other. When a patient is undergoing a surgical hairline lowering, the hairline incision is used.

In very limited, specific circumstances, it may be best to undergo orbital rim contouring through an upper eyelid incision. An upper eyelid incision is also referred to as a transpalpebral approach (trans = through and palpebra = eyelid). This type of approach to the orbital rims is technically more demanding and it is more difficult to achieve dramatic results.

Approaching the orbital rims through an upper eyelid incision allows the surgeon to primarily reduce the orbital rims and some of the central brow prominence. In general, it will not allow full access to the entire brow prominence to allow for a formal brow bone setback / brow bone reduction.

The before after photographs shown above demonstrate the degree of orbital rim contouring that can be obtained through an upper eyelid incision (transpalpebral approach) and the limited scarring that Dr. Mittermiller was able to achieve.

Dr. Mittermiller is a specialty trained plastic surgeon who primarily operates in the Los Angeles area. He is passionate about craniofacial surgery, gender-affirming surgery, and rhinoplasty.

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