Orbital Rim Implants, Sub Periosteal Mid Face Lift and Long Term Complications?

I am in the UK and am seeking to treat sub orbital volume deficiency coupled with weakening of the orbital septum. I understand that I may benefit from upper and lower bleph with arcus marginalis release and fat transpositioning. It has also proposed I would benefit from orbital rim implants with soft tissue suspension. I am concerned about the visibility of implants as my face continues to age, and is it does whether it will expose the implant. The skin surrounding eyes is painfully thin!

Doctor Answers 8

Eyelid surgery

Sounds to me like you are going to be over operated upon.  I don't like fat injections in the eyes.  I've seen some results that are terrible!  

San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Facial Implants

Facial implants have pros and cons that need to be discussed with your surgeon.  The implants do not age with you and the skin and tissues over the implant will thin over time.   Another option is fat grafting which is natural and will age with you.

Craig Mezrow, MS, MD, FACS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 17 reviews

Fat Grafting in Lower Lids

It is very important to preserve (or restore) soft tissue volume in the lower lid. When I review with eyelid surgery patients some photographs from their twenties, in most cases we find that years ago there was no visible demarcation between lid and cheek, but instead a smooth, gently convex curve extending downward from the lower lid margin.
In patients who have developed deep 'tear troughs' at the junction of the lower lid and cheek, adjacent to the side of the nose, the meticulous grafting of fat harvested from the patient's abdomen, hips or thighs can build this area back up and nicely restore a more youthful contour. In some blepharoplasty patients this depression or 'hollow' extends horizontally across the entire junction of the lower lid and cheek, and this must be corrected to obtain the ideal postoperative result.
In select patients, lower lid rejuvenation may consist of conservative reduction (not removal) of the lower lid fat pads or 'bags', in combination with structural fat grafting of the 'tear trough' hollow immediately below. As with all aesthetic surgical procedures, it is absolutely essential to customize the surgical plan to the specific needs of every patient.
Please have several consultations, view many, many before and after photographs and speak to patients who have had the surgery that has been proposed for you. I wish you the best.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Orbital Rim Implants and Midface Lift Complications

       Orbital rim implants may be a reasonable option along with midface lift.  You will hear varying perspectives on the this issue and this is largely paradigmatic in nature.  Some surgeons will avoid implants in favor of more natural substances.  I cannot argue in favor of one over the other without pictures and an exam.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Orbital rim implants are indicted in very specific circumstances.

Unless you have previously been wrecked by lower eyelid surgery, you most likely do not need an orbital rim implant.  Instead fillers are now the state of the art for providing this type of volume replacement.  It is critical however, to find an injector close to home who can perform this type of service for you.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Orbital rim implants

I am not a big fan of facial implants ( excpet maybe for chin).  Especeially now that we have facial fillers that do such great jobs at improving these areas.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Orbital Rim Implants (Tear-Trough Implants)

Orbital rim implants combined with arcus marginalis release and fat re-positioning is an excellent way to address the hollowing and bags under the eyes.  This is a procedure I have done hundreds, perhaps thousands of times.  There is no doubt that experience is important for an uneventful recovery.  The implants will not become visible as you age.  I have been performing these for nearly 10 years on people as young as 20 to as old as 75.  The implant does not sit under the skin, it sits under multiple layers of tissue including skin, fat, muscle, and periosteum.  The volume produced by this combination is natural in appearance both at rest and with facial animation (smiling, squinting, etc.).  The implant does not move with the soft tissue, it is essentially one with the bone and the soft tissues slide over the top of it just the same as with tissues over bone.  Unlike fat transfer, the implant has a known shape and size that will not vary with the amount of "take" that occurs.  It will not go away with time as fat transfer does and it will not bunch with smiling.  It is also removable which is not the case in the event of a fat transfer with an uneven, exceedingly full, or otherwise distasteful result.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

Avoid orbital rim implants in eyelid surgery.


Quite high incidence of problems with these implants.  I don't use them.  Mid facelift safe only when done through the mouth, not through the eyelids.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 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.