Is the Arcus Marginalis Always Released when Placing a Tear Trough Implant Through an Incision Inside the Lower Eyelid?

If the implant is placed appropriately in the subperiosteal space then yes the arcus marginalis must be released. The arcus is a band of what we call connective tissue which is a condensation of bone lining from the floor of the orbit and the bones of the face. When it is incised an implant can be securely placed between it and bone. Best Dr. Massry

If you are going to have a tear trough implant place from an incision behind the eyelid, then yes the arcus marginalis must be releases. Generally for the purpose of this surgery, what we are talking about is incising the periosteum at the orbital rim and making a subperiosteal dissection onto the face of the cheek bone. The acrus is not actual cut in that case. Note that the arcus is simply the condensation of the orbital septum where it fuses with the periosteum of the... more

Tear trough implants and seperation of the orbital septum from the orbital perisostum has lost favor and popularity in the last decade. I have had a good experience with use of "Biomatrix" tissue regeneration placed under the orbicularis muscle orbital rim retraction. This strengthtens and fills the transition between orbital septum and anterior maxillary wall rejeuvinating this difficult area.