I have had custom infraorbital rim implants but they are too big for my face it seems. I want something that is natural and hardly noticeable: that adds volume where it was lacking, reduces some scleral show but essentially keeps my same eye shape - at the moment my right lower lid has gone. At the moment I can clearly discern the outline of both implants. I think the implants add far too much volume and was wondering how to design an implant to get my desired look in the revision surgery.
Answer: Removal of infraorbital rim implant Infraorbital implants are complex procedures and some patients just don't well with implants and the implant should be removed rather than revised but every patient/anatomy is different so individual evaluation is important.
Helpful 1 person found this helpful
Answer: Removal of infraorbital rim implant Infraorbital implants are complex procedures and some patients just don't well with implants and the implant should be removed rather than revised but every patient/anatomy is different so individual evaluation is important.
Helpful 1 person found this helpful
December 11, 2020
Answer: It is important to understand that you have had a very unusual primary surgery. I do not offer orbital rim implants as a cosmetic solution to patients who have not had primary surgery. I have done this in the past and I do have very happy patients from this work. I have also had patients who decided that they did not like the effect and eventually asked for the implants to be removed or modified. I have had patients who have had persistent swelling or other issues. Approximately 15 years ago, we got reliable high G prime hyaluronic acid fillers that made it possible to reliably correct many of the issues for which the orbital rim implants were being used for. The fillers are not perfect. Placement requires a true artist with a detailed knowledge of the midface. However, they can be replaced, modified or completely removed as an office service with no surgery. That alternative caused me to rethink who I offer orbital rim implant surgery to. I no longer offer it to individuals who have not had prior eyelid surgery. Yes, I had successes but even a small number of unhappy individuals makes these surgeries less appropriate for most everyone given a safe alternative. However, the issue is entirely different for you as you now have compromised lower eyelids. I have developed a comprehensive approach to these types of lower eyelids which have an unsatisfactory rim implant. One does not need a CT scan to understand that this implant is not appropriate for you. Unfortunately, placing these can cause permanent damage to the muscles that hold the lower eyelid in place. It is possible to compensate for these changes with revisional techniques, however it is not possible to fully restore this motor function. I generally hand carve a rim implant for my patients using a block of surgical ePTFE. This material is FDA approved for deep facial implantation. I am attaching a link to my website with more information and a link to a graphic video showing how these surgeries are performed. There is no substitute for a detailed, in person consultation.
Helpful 1 person found this helpful
December 11, 2020
Answer: It is important to understand that you have had a very unusual primary surgery. I do not offer orbital rim implants as a cosmetic solution to patients who have not had primary surgery. I have done this in the past and I do have very happy patients from this work. I have also had patients who decided that they did not like the effect and eventually asked for the implants to be removed or modified. I have had patients who have had persistent swelling or other issues. Approximately 15 years ago, we got reliable high G prime hyaluronic acid fillers that made it possible to reliably correct many of the issues for which the orbital rim implants were being used for. The fillers are not perfect. Placement requires a true artist with a detailed knowledge of the midface. However, they can be replaced, modified or completely removed as an office service with no surgery. That alternative caused me to rethink who I offer orbital rim implant surgery to. I no longer offer it to individuals who have not had prior eyelid surgery. Yes, I had successes but even a small number of unhappy individuals makes these surgeries less appropriate for most everyone given a safe alternative. However, the issue is entirely different for you as you now have compromised lower eyelids. I have developed a comprehensive approach to these types of lower eyelids which have an unsatisfactory rim implant. One does not need a CT scan to understand that this implant is not appropriate for you. Unfortunately, placing these can cause permanent damage to the muscles that hold the lower eyelid in place. It is possible to compensate for these changes with revisional techniques, however it is not possible to fully restore this motor function. I generally hand carve a rim implant for my patients using a block of surgical ePTFE. This material is FDA approved for deep facial implantation. I am attaching a link to my website with more information and a link to a graphic video showing how these surgeries are performed. There is no substitute for a detailed, in person consultation.
Helpful 1 person found this helpful
