If one has lower eyelid retraction could orbital rim implants actually raise the lower lids to show less scheral show?

Question

i personally think orbital rim implants can do this. i know for eyelid retraction you can do a canthpexy etc if one has orbital rim implants and canthopexy...is there a chance of further retraction

David Tauber, MD · Answer

Lower lid retraction can due to a number of factors and is
a reflection of the relationship between the globe, the facial skeleton, and
the overlying soft tissues. Prominent globes, a negative skeletal vector, a
lack of eyelid skin, lax lower lids, or excessive downward pull of the cheek
skin can all cause scleral show individually or in combination. Treatment for
scleral show, therefore, is tailored to the cause and can include infraorbital
implants, orbital decompression, skin or mucosal grafts, a canthopexy, and / or a
midface lift. A detailed examination will help delineate the best
option. Follow-up with a plastic surgeon would be the next best step.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Orbital rim in class will not improve lower eyelid retraction. Lower eyelid retraction is due to either a shortage of skin or shortage of the tissue between the skin and the inner eyelid mucosa.

Mehryar (Ray) Taban, MD, FACS · Answer

Yes, the combination of orbital rim implant with soft tissue lifting over them can improve or eliminate scleral show. Best to see an oculoplastic surgeon.

Kenneth D. Christman, MD · Answer

Orbital implants are not needed here.  However, a competent surgeon should reposition the soft tissues in order to reduce scleral show.

Robin T.W. Yuan, MD · Answer

Scleral show is caused by a number of anatomical factors. Lack of skeletal support as evidenced by a negative vector would suggest that implants along the lower orbital rim could provide additional support to eyelids that sag due to lack of support. However, a full examination is required to determine specific additional causes like lack of muscle tone, laxity of the canthal tendon, or soft tissue lid shortening.Robin T.W. Yuan, M.D.

Matheson A. Harris, MD · Answer

Lower eyelid retraction can be corrected by several methods, which depend on your anatomy. Often, people with fairly flat cheek bones and more prominent eyes get lower lid retraction as they age. The lower lids lack support and need some volume to hold them up.  Malar implants are used to build up this volume, usually along with an eyelid tightening procedure and/or a mid-face lift. However, if there is only mild retraction or you have good cheek bone structure, you may just need something to prop up the lower lids to return them to a good position. This is where a tissue graft such as ear-cartilage or donor cartilage on the inside of the lower eyelid is very effective.  See an oculoplastic/orbit surgeon for a consultation.

If one has lower eyelid retraction could orbital rim implants actually raise the lower lids to show less scheral show?

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