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Hard palate graft or any other internal eyelid spacer graft is not the main determining factor in surgery success for lower eyelid retraction repair. The actual lift of the lower eyelid is critical.
I have patients who had a hard palate graft placed 20 years ago and the graft is still doing its job. It is not enough to use a hard palate graft. In order to correct your mid face issue, skin and soft tissue needs to be recruited into the eyelid. This is best done using a method I developed that elevates the midface vertically and holds that tissue in place with an ePFTE rim implant. The hard palate graft is used for controlling the shape of the lower eyelid. It can not be relied on to accomplish all structural aspect of the surgery.
Hard Palate graft should provide great longevity for the treatment of lower eyelid retraction. The issue for long term results becomes the aging and laxity with gravitational descent than can occur around the graft. Patients may need adjustments or revisions in their lifetime after the hard palate graft to maintain the integrity of the lower eyelid and cheek supporting the graft. Hope this helps.Kind regards,Malena Amato MD FACS
Thank you for the question, a photo would help in terms of specific recommendations but in general for lower eyelid retraction there are two major ways to address the problem. First, as you mentioned negative vector and mid face deficiency, one option to address lower eyelid retraction is...
Simply placing a hard palate graft to reconstruct the lower eyelid should lengthen the eyelid and impove its position on the globe. However, It will not recruit skin and soft tissue into the eyelid. This means that despite the surgical work, the weight of the cheek will continue to work a...
Typiaclly, skin graft can be an option if too much skin was removed from a lower lid in previous surgery, from trauma or scarring, or after tumor removal. The ideal skin graft for your lower eyelids is your upper eyelid skin, but in front of or behind the ears have also been used. There are...