Would I benefit from an orbital rim implant? (photos)

Question

I'm 26 years old and have found that I metabolize filler quickly so I am looking for something more permanent. I hate my droopy eyes and hollow under eye area.

Mehryar (Ray) Taban, MD, FACS · Answer

Best to get in person consultation. You have inherited lower eyelid retraction with sclera show. You may be a candidate for lower lid retraction surgery to achieve more almond shape eyes. At the same time, orbital rim (or tear trough) implant can be placed through hidden insider lower eyelid incision approach. See link below.

Brent Moelleken, MD · Answer

Lower eyelid surgery can be done to minimize scleral show, but still preserve an almond shape of the eye.  In our practice this would involve a short incision cheek lift.Tear trough filler may still be necessary to smoothen out things further.

Kenneth D. Steinsapir, MD · Answer

I truly question if there are "fast metabolizers" of filler.  More often than not, this turns out to be inadequate or poorly placed fillers.  The surgeries do have side effects.  For cosmetic purposes the fillers have largely replaced tear trough implants except for post blepharoplasty reconstruction.  When there is a reconstructive need, the risks and expense of orbital rim/vertical mid face lift surgery is certainly warranted.  What strikes me when I look at your photos is superior orbital atrophy and the relative inferior scleral show from low placed lower eyelids.  This makes your personal situation different from many others.

Barry L. Eppley, MD, DMD · Answer

Since injectable fillers do not last the only permanent solution for your under eye hollows would be orbital rim implants. With your natural lower lid retraction and increased scleral show, placement through any type of eyelid incision must be done very carefully to avoid aggravating your lower eyelid position.

George Orloff, MD, FACS · Answer

Short answer--- No.   Your areas of concern regarding the eyes are visible.  Your eyes bulge a little bit.  The Lower eyelid droops down as you go to the sides of the eyes.  This is not aging and it is not something that resulted from some sort of injury.  I would recommend having your primary care physician evaluate you for any thyroid issues.  Once this is cleared, I would recommend surgery to create a straighter lower eyelid (raise the sides).  I think filler in the area is a better alternative but will not change the shape of the lower eyelid.

Richard O. Gregory, MD · Answer

You are attractive and therefore I recommend against doing anything.  Remember that everything carries risk. Permanent implants can shift and rotate, erode and become infected.  Occasionally tissue can grow under them and lift up the edge.  The advantage of doing something that is temporary is in fact that it is temporary.  Contrast this with an implant which even if removed because of problems leaves scar tissue and other problems behind.

Would I benefit from an orbital rim implant? (photos)

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