The hourglass facial deformity.

The "Hourglass Facial Deformity" is the result of bilateral irradiation of the orbits and anterior cranial base during infancy. The deformity is uniformly characterized by a distinctly misshapen upper face at the level of the orbits, with depression of the temporal region, hypotelorism, and flattened nasal root. These patients exhibited varying degrees of frontal bossing. Since they had previous enucleation, the orbital soft-tissue can be dissected off the eye socket, lateral orbital walls, and if necessary, the orbital cone, through a bicoronal incision. The deformity is then easily corrected with implantation of acrylic alloplastic material. Four cases are presented which had varying degrees of the same deformity and were successfully corrected using the operative procedure described. No complications have been encountered. Two patients required eye socket revisions.