What makes implants (orbital rim/malar) better than fillers for correcting hollows/orbital rim deficiency? (photo)

 How do the results compare?

Doctor Answers 13

Malar Implants

Although fillers are alternative to implants, they are temporary and repeated injections are needed. They are obviously promoted by those who do not perform implants and are not facial plastic surgeons. Malar implants are the most obvious choice in patients who have hypoplasia of facial bones and are looking for a more permanent solution. 

Orange County Facial Plastic Surgeon
4.6 out of 5 stars 12 reviews

What makes implants (orbital rim/malar) better than fillers for correcting hollows/orbital rim deficiency? (photo

from one picture, you look young with beautiful eyes. You are not hollow, you are thin with dark circles which neither fillers nor an implant will improve.  

Filling the area in will change your look considerably, not necessarily for the better,  and in someone thin the problem is visibility of the implant or filler and what it looks like at the edge of the implant.

Just BTW,  HA fillers like restylane uner the eyes last 2-4 years.   YOu can dissolve  them if you don't like the look

Val Lambros, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 6 reviews

Eye hollow

huijonglee, Try fillers before implants to make sure you like what you see. Implants are permanent (although silicone implants are easy to remove), not a bad idea to try a temporary fix before signing up for a permanent one. For hollow eyes I use a "SOOF lift blepharoplasty" which works extremely well. See my web site for further information. Good luck!!!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.8 out of 5 stars 44 reviews

Malar Hypoplasia

Implants are a permanent correction of an anatomical problem. Fillers are a temporary camouflaging of the finding.  Fat transfer is a more long lasting camouflage technique.  All are acceptable treatments. Best wishes.

Orbital rim implants vs fillers

Off the shelf fillers (e.g. Juvederm), fat transplants and permanent implants are all accepted treatment.
Orbital rim implants give an excellent and permanent result - but surgery costs more at one time compared to fillers and there can be complications.
Fat injections have predictable results in some surgeon's hands, but can resorb in 3 months - and need to be redone.
Filler injections give about 1 year of improvement and are done in the office. In time they cost much more than surgery. They can cause blue discoloration in the skin and permanent lumps (granulomas) that need surgical excision.

All are reasonable choices. 

Fat grafting best for correcting hollows/orbital rim deficiency.

Fat grafting is the best solution because:
  1. It is permanent when properly done- unlike temporary fillers 
  2. The stem cells resident in the fat rejuvenate the overlying skin
  3. The surgeon has more flexibility in distributing the volume where it is needed- unlike implants 
Check out the web link below for the proper way to process fat so it is permanent and the video below to see how fat grafting improves facial contour. 

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.4 out of 5 stars 88 reviews

Fat transfer

Facial rejuvenation through volume changes is one of the most common means around the eyes and cheeks. It used to be that implants were always used. Today I almost never use implants anymore. They are foreign material and have many problems. You can try fillers, but I utilize advanced fat transfer techniques that lasts forever. Facial fat grafting is the key to facial rejuvenation. I would look into this more specifically with an advanced cosmetic surgeon to  see I you are a candidate. Best wishes.

Filler vs orbital rim implant

In the past, when fillers weren't available, rim implants were used more often. However, they are much more invasive with various possible side effects. In the age fillers, they have become almost obsolete, except in rare circumstances. That is not you. Fillers are safer and more predictable and reversible. They also tend to last a long time around the eyes.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 58 reviews

Rim implants are not better than fillers!

Rim implants have very specific indications.  They are irreplaceable when skin must be recruited from the cheek to reconstruct the lower eyelid after lower eyelid blepharoplasty complications, post trauma reconstruction, and certain post cancer reconstruction situations.  While the rim implant can be used to increase cheek bone projection, that is not its essential function in these cases.  It's essential function is to create a place to sew the lifted cheek to at the orbital rim which is necessary as a way of bringing cheek skin into the lower eyelid.

I do not agree with Dr. Mackenzie that rim implants are needed when there is poor bone projection at the orbital rim.  The hyaluronic acid fillers have proven to be a fantastic alternative to surgery even in these situations.  So unless you really need skin recruited into the lower eyelid, fillers have proven to be a far better alternative to rim implant surgery.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Fillers or implants for orbital rim?

Fillers or implants for orbital rim? Each has advantages and disadv. Quick fix lasting 1-2 years . Fillers. Permanent fix and less cost over time -implant 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 32 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.