Orbital Rim Implants For Hollow Eyes; Anything Just As Effective? (photo)

Question

I'm a young 24 year old but I have really bad Hollow eyes. It has been hard to find another case like mine, but I found one that is similar to me. I want your opinion on this case. What procedures would you do? Would it be as effective

A.J. Amadi, MD · Answer

Injectible fillers [Restylane/Juvederm] and fat grafting are techniques that are more in vogue in addressing the problem you are concerned about. Facial implants still have a role, but at this point the degree of your underlying skeletal anatomy does not warrant an implant, in my opinion.

Toby Mayer, MD · Answer

The easiest, and quickest treatment for this is Juvederm or Radiesse. Fat in this area is very unforgiving and I see many patients with lumps after having this. The exception is when done in combination with a blepharoplasty.

Kenneth D. Steinsapir, MD · Answer

To not have implants to correct this. I developed an ePTFE orbital rim implant. However, the fillers are so great that most people are loving the under eye fillers. I now reserve the orbital rim implants for individuals who have had a complication from lower eyelid surgery. I actually think that Restylane is much more versatile that surgery. Finding the right injector is the key.

Barry L. Eppley, MD, DMD · Answer

While there are a variety of volume addition options to the tear trough area, the first place to start is with injectable fillers. You want to be certain that actually filling the area will create the effect that you want. Any of the hyaluronic acid-based fillers will provide a quick answer that is completely reversible. If you like the effect created then you can decide if repeat filler injections, fat injections or a variety of implant materials are a better option.

Peter A. Aldea, MD · Answer

The Tear Trough or Nasojugal fold is at the junction of the lower lid and cheek. With the ease and versatility of fillers, especally of Restylane, implants were largely displaced to a much less used solution in this area. Fnd a Plastic surgeon experienced with treatment of this area.

Louis W. Apostolakis, MD · Answer

The upper cheek/lower eyelid area goes by different names, but commonly the groove or hollow that can be found there is called a tear-trough.  Some people have a tear-trough as a matter of genetics while others develop it with age.  If you are young and have it, the reason is almost certainly skeletal shape.  People who develop it with age may have a skeletal predisposition and then as they age they lose some skeleton (osteoporosis of the skull), have loss of upper facial fat, and some loosening of a piece of tissue called the orbital septum.  The orbital septum contains the fat that surrounds your eyeball and stretching of that tissue in combination with loss of bone/soft tissue below it results in bags.

	Techniques for correcting the problem include soft tissue filling and implants.  For mild cases, Restylane is my preferred choice.  When the condition becomes more severe or if the patient desires a more permanent correction, implants are an excellent choice.  The implant surgery serves to augment the skeleton.  Once in position, it looks and behaves just like bone.  The implant is very consistent, it does not change with time, it works on young and old people, and it is very natural.  Unlike fat, it does not fail to "take" and can not be lumpy or irregular.  It also will not bunch up during smiling as all soft tissue fillers (fat or Restylane) will do when used in excess.  For severe cases, soft tissue filling simply can not accomplish what an implant can. When the patient also has stretching of the orbital septum, this can be corrected at the same time smoothing and redistributing that fat so as to smooth the entire area out.  The end result is a full and youthful upper cheek/lower eyelid transition area.

	Placement of a tear-trough implant is not something that most surgeons are familiar with.  If you desire such an implant, I recommend you visit someone who does them on a regular basis.

Steven Schuster, MD, FACS · Answer

Although the implants are a possibility, this is not something I have used. I would try a lipoinjection of fat to the sulcus. You must use a board certified plastic surgeon with experience in this procedure to avoid complications. Do your homework and see several doctors before you decide to proceed.

Orbital Rim Implants For Hollow Eyes; Anything Just As Effective? (photo)

Answers (7)

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