I need professional advice (please) Cosmetic Orbital Decompression or Lower Rim Implant?

I am in the orbital rim business.  I do not recommend orbital rim implants for you.  You would to great with hyaluronic acid fillers at the orbital rim.  You can't go down the street for this service.  You likely need about 2 ml of Restylane under each eye.  It is a fussy service.  Orbital rim implants are important when the lower eyelid has been wrecked and there is a lack of bone projection.  As a primary cosmetic surgery, orbital rim implants are far from idea.  In considering an orbital decompression, it is also important to understand that this surgery has a very high risk of causing permanent loss of vision due to orbital hemorrhage.  Studies of orbital surgery and orbital decompression suggest this rate of visual loss might be as high as one in 500 cases.  That is an extraordinarily high number that temper anyone's enthusiasm for such surgeries. 

Either option (orbital decompression vs. lower orbital implant) is possible, each with pros and cons. Best to seek personal consultation with experienced orbit, oculoplastic surgeon. See link for published manuscript on orbital decompression in patients without graves disease.

You do not have a true orbital proptosis, rather you have a significant infraorbital-malar skeletal deficiency. Infraorbital-malar implant augmentation would be the correct procedure. Such implants are best made in a custom fashion from a 3D CT scan.

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. 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. In fact most find
it life changing as you can find out from our patients Patients, come to us
looking to improve their appearance if their eyes are bulging.  Not
everyone has bulging eyes so it is important to customize the process.  If
someone has bulging eyes then we can consider several options including a
surgery to reduce the bulging. To reduce eye bulging we will remove fat or
shave a little bone to reduce the prominence.  This surgery is done under
general anesthesia and takes about an hour and patients recover in about two
weeks with bruising and swelling 


You should have an evaluation by a qualified
oculoplastic surgeon for evaluation 

Having done many orbital decompression I would not do one for purely cosmetic reasons. The potential risks outweigh the potential benefits.