Surgical decompression of orbit could very well alter facial appearance. Patients with thyroid associated orbitopathy should be warned that only a marginal improvement to facial appearance is possible
Orbital decompression Procedure
Orbital decompression is the partial or complete removal of one or more, of the four walls of the orbit (eye socket). This procedure is primarily performed for Graves' disease (thyroid eye disease). Graves' disease frequently includes some combination of thyroid disease, bulging of the eyes (exophthalmos), lid lag, retraction of the eye lids and double vision (diplopia).
Endoscopic orbital decompression is a surgical procedure which is usually performed under a general anesthetic (going all the way to sleep). Going through your nose, your surgeon will first perform endoscopic sinus surgery and open the sinuses directly beside the eye (frontal, maxillary, ethmoid, and sphenoid sinuses). Once this is complete, the bone along one side of the eye (closest to the nose) and sometimes also part of the floor of the eye is carefully removed.