[oahz]

#1059595

after watching a view videos of the bony decompression, i cannot subject myself to that.

please, anyone, if you have ANY info, links, or videos on the fat decompression surgery please share it with me.

if they are not allowed, please PM me.

and if you had had a fat decompression please share your experience and answer these questions:

what kind of thyroid disease do you have? fat enlargement, muscle enlargement or both? the CT Scan should tell.

how many mm of proptosis did you have on each eye pre op?

how many mm of reduction did the surgery done for each of your eyes?

do you know how many ml of fat your surgeon removed from each eye?

did you get double vision?

[snelsen]

#1176032

The only comment I have is, that it is not really a choice between the two, but I imagine you realize that. Your surgeon can show your your orbital CT scan, and show you if you do/don’t have any orbital fat. Speaking in very general terms, the bony decompression is what usually needs to be done to make the orbit larger, to accommodate the bulk that has accumulated with the enlarged, fibrotic muscles (which do not get better or smaller.)

I am not aware of any video, but it may be included in the OD compression videos you have watched.
Shirley

[gatorgirly]

#1176033

I know it sounds scary (people balk when I tell them what I had done), but you cannot tell that there is bone missing. I actually had both bone and fat decompression – both medial walls, both orbital floors, and fat behind the eyes. My surgeon personally limits lateral wall decompression to extreme/severe proptosis, and mine was only moderate. However, the results were phenomenal – no double vision, 4mm decompression in left eye, 6mm in right eye, both now at 19mm. It doesn’t look like any bone is missing and I cannot feel it. Trust me, it sounds a heck of a lot worse than it is.

But ultimately, Shirley is right in that your surgeon will outline the best plan for you. Who knows, it may not involve any bone. At first, my surgeon looked at me, reviewed my CT and said, “I don’t want to do any bony decompression, just fat. Bony runs a higher risk of double vision.” Then I showed him the photos of me before TED and he quickly changed his tune. Although my proptosis didn’t look too bad to people who didn’t know me before TED, it actually was very noticeable because my pre-TED eyes were so deep set and “squinty.” So he decided both bony and fat would give me the best chance at looking like my old self.

I’m happy to report that except for all the extra weight this Graves’ roller coaster has left me with, I do look like my pre-TED self.

[oahz]

#1176034

when it comes to the lateral wall, i can’t imagine that you won’t be able to tell that a bone is missing. i mean, they bore a hole in the side of your skull? what happens if you were to use your hand and push against the side of your skull?

as for the fat decompression, my proptosis on my left eye is only 1.5mm.

based on the research that i have done i am getting all sorts of contrasting opinions on the fat decompression.

i have heard:

1. it depends on the surgeon’s experience and preference.
2. it depends on whether muscle enlargement or fat enlargement.
3. it depends on the amount of proptsis. if only 2-4mm, then fat decompression is enough.

i have also heard that the complication rates are much lower with fat decompression, and also heard that it is higher.

[gatorgirly]

#1176035

As for your last comment, it probably depends which complication you’re talking about. My surgeon does hundreds of ODs a year and said the chance of developing double vision with a fat decompression is lower than with a bony decompression or a combination of the two. Still, I had no complications and no double vision with the combination of decompressions. The medial walls were done endonasally, the floors were done through my lower lids, and the fat was done through my upper lids.

Sounds like a second opinion might relieve some of your concerns, but then again, every surgeon is going to have a different approach and different personal stats.

[Kimberly]

#1176036

Agree with gatorgirly that you still seem to have a lot of unanswered questions/concerns and that a second opinion might give you a higher level of comfort.

The American Society of Ophthalmic, Plastic, & Reconstructive Surgery has an option on their site to find a surgeon:

(Note on links: if you click directly on the following link, you will need to use your browser’s “back” button to return to the boards after viewing, or you will have to log back in to the forum. As an alternative, you can right-click the link and open it in a new tab or new window).

http://www.asoprs.org/custom/directory/?pageid=3657&showTitle=1

You can search by city, state or zip to find a doc near you.

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