A 49-year-old female with advanced left maxillary squamous cell carcinoma underwent total maxillectomy. The orbital floor was reconstructed using a titanium mesh implant and the midface reformed with a free fibula flap. Following reconstruction, the patient developed progressive left-sided proptosis. Review of postoperative imaging prompted extraction of the titanium implant, rapidly normalizing globe position. This unique case highlights the clinical relevance of orbital venous anatomy.