Shallow orbit. Would orbital rim implants help my lower eyelid (Photos)

Question

Would they create a smooth transition or will they need extra filler? Or would filler be enough? My lower eyelidsticks out a bit like a frog. Would orbital decompression help this? Combination of 2?

Mehryar (Ray) Taban, MD, FACS · Answer

There are various options, some of which you mention in your post. It is best to see an oculoplastic surgeon for in personal evaluations and discussing pros/cons of various treatment options.

Nelson Lee Novick, MD · Answer

A frontal photo would have been extremely helpful to complement the profile shot you provided. However, it appears from what I can actually see that you might profit from the simple use of a filler to smooth the transition between the upper portion of your cheek and the bottom-most region of the lower eyelid. Belotero Balance would be my choice for this purpose in my Upper East Side Manhattan office, since it is smooth, cohesive, easily moldable and possesses little to no tendency to give rise to the unwanted bluish Tyndall Effect when injected superficially into the delicate tissue in this region. (Teosyal Redensity II would be my choice in my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available.) In experienced hands, this procedure should take no more than a few minutes to perform and engenders little to no significant downtime. The under eye region is not a place for novice injectors or medspas. So, make certain to seek consultation and treatment by a board certified aesthetic physician with experience and expertise in treating this area and insist upon seeing his/her before and after photos. Best of luck to you and Happy New Year.

Barry L. Eppley, MD, DMD · Answer

You have a negative orbital vector, meaning your inferior orbital rims are recessed. Your eyeball is actually normal but looks like it is sticking out too far because of the relative bone deficiency. While synthetic fillers and fat can be tried that is a hard area to have sustained success and a symmetric smooth augmentation. Custom made orbital rim implants offer the best sustained augmentation that creates not only horizontal but some vertical rim augmentation as well.

Paul Nazemi, MD · Answer

Thank you for your question and sharing your photos.  There are often various treatments to address a problem, and each having its own risks and benefits.  Dermal fillers are less-invasive and non-surgical, and can address some issues nicely and without the need for surgery.  See a specialist for a comprehensive evaluation and to determine the best treatment(s) to address your concerns.

Raymond S. Douglas, MD, PhD · Answer

Thanks so much for the question.

I think you have great nonsurgical options available even though it is very hard to see in the photos provided.

Some people have very prominent eyes. Often this is caused by a medical condition called graves disease or thyroid eye disease.  But often it is due to trauma or just being born that way.  This can be quite concerning for many people in that it makes them appear intense or not normal.  Many patients ask if there is anything that can be done and in the past the answer was not too much at least safely

Now that is untrue. We specialize in moving the eyes back or improving this "bulging" appearance for patients using surgical and nonsurgical methods. This is specialized surgery that very few doctors would offer but our group has done thousands of these surgeries and our patients are very happy.  Bear in mind that not everyone has bulging eyes even if it can appear that way.

The first step is a complete asssment which can often be started online.  Once you find out all the options including procedures to camouflage or reduce the appearance of eye bulging.

You should have an evaluation by a qualified oculoplastic surgeon for evaluation and then consider all options.

Michael Carlisle, MD - Account Suspended · Answer

From your photos it is clear that you have what's called a negative vector. That means the bone under your eye (orbital rim/cheek) is set back behind the front of your eyeball. This problem is often not noticed by average surgeons and if unnoticed can cause problems with your lower lid becoming droopy after a lower eyelid surgery. To perform lower eyelid surgery and make your eyelid more youthful you also need something to fill out your orbital rim and give your lower eyelid support...this also makes you more youthful, balanced, and less tired looking. You're right, some people can look more youthful with conservative fillers here but yours is severe enough to need an orbital rim/cheek implant. I perform these under general anesthesia at the se time of eyelid surgery or chemical peel to improve youthfulness.

Michael Carlisle, MD

Cleveland Clinic Cosmetic & Reconstructive Center-Trained Plastic Surgeon

Michael Carlisle, MD

Cleveland Clinic Cosmetic & Reconstructive Center-Trained Plastic Surgeon

Shallow orbit. Would orbital rim implants help my lower eyelid (Photos)

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