How likely is lower eyelid retraction after cheek implants/orbital implants are done through lower eyelid?

Eyelid retraction from doing cheek implants thru the lower eyelid? Good question! I have done this many times over the past 35 years and never had lid retraction. This requires an experienced eyelid surgeon so that no tension is placed on the lower lids.

Actually the specified procedure you mention can be tailored to correct lower eyelid retraction, if needed. It all depends on what the goals are and how the surgery is performed. See an oculoplastic surgeon.

In our practice, we place all cheek implants through an intra-oral oral approach under brief general anesthetic. The implants are placed underneath the periosteum directly over the maxilla underneath all the tissues of the cheek. This prevents any muscle injury to the mid face and eyelids which can cause retraction. Cheek implants will not raise the lower eyelids. For many examples that more information, please see the link and video below

Because it is necessary to use a lower eyelid incision and cheek tissue dissection to place orbito-malar implants, there is always risk of lower eyelid retraction. Preventative measure include a lateral cantopexy and orbitcularis muscle resuspension. These are two eyelid management techniques that I incorporate into every orbital rim implant procedure.

The problem here is that to elevate and stabilize your eyes you are using a surgical approach that destabilizes the eyes and this is foolish.Cheek implants are a great solution to your problem ,however they should be placed in position from under the upper lip on each side and thereby not weaken the orbital complex. This will add fullness to the peri-orbital rim and also enhance the cheekbones and midface.In my office cheek implants like this are done with simple oral sedation and local anesthesia injections. There is minimal discomfort and the whole operation takes 45 minutes to do both sides nicely. It is no problem to place the implants right at the orbital rim from this approach, it is actually easier.