Follow-up question: Could orbital rim implants or a mid facelift along with a canthoplasty help this issue? (Photos)

The purpose of the orbital rim implant is to function as a felting material: a place to sew the lifted cheek to along the orbital rim. For each patient at the time of surgery, I hand carve a rim implant of ePTFE. This material is fixed to the bone with microscrews. The purpose of this is to permanently support the lift cheek.  The cheek is lifted to permanent bring extra skin and soft tissue into the lower eyelid without the use of an unsightly skin graft. To control the shape of the eyelid, I also use a pendant shaped strip of hard palate graft from the roof of the mouth. This is sewn in behind the lower eyelid to control the shape of the lower eyelid.  No one sees this. Some surgeons cut corners and do not provide felting material to help hold the lifted cheek.  Some surgeons use a product called Alloderm to shape the lower eyelid. The problems with these two steps is that over time the cheek will fall without permanent fixation and support. The Alloderm, which is very convenient to use (just open the package), is a foriegn tissue. The body rejects this material. After about 3 months, it all disappears. The wonderful result that you see right after surgery rapidly fades in time.  For these reasons, developed a more definitive approach that holds up over time. There is no substitute for a personal assessment.

My experience is a SOOF lift would be helpful. It is a mid face lift and helps to pull the lower lid upward without downward traction