How can I correct hollow between eye and orbital bone?

Question

I had lower eyelid fat repositioning to fill tear troughs which worked great but I have a hollow crease between my eye and the top of the orbital bone. I was looking at the midface rim implants as they seem to extend to the outer part of the orbital rim where the hollow is most evident. I also wanted the lower lid lifted to make them less droopy/retracted and create a more positive canthal tilt. What procedure/s would benefit me most?

Zoran Potparic, MD · Answer

It seem that part of your problem is related to small cheekbones. Correction of that problem with periorbital implants, possibly with canthoplasty, would be one of the solutions to be considered. In person consultation with a board certified plastic or occuloplastic surgeon with good reputation in cheek implants is suggested. Good luck.

Kenneth D. Steinsapir, MD · Answer

As you point out, you have a negative vector lower eyelid. Your lower eyelid position is actually compromised and this may be related to your lower eyelid fat repositioning surgery. Normally it is not expected that this surgery would compromise the lower eyelid position. Was your surgery done from behind the lower eyelid (transconjunctival) or through the skin (transcutaneous)? Normally it is the transcutaneous surgery that compromises the position of the lower eyelid. Normal but occasionally we do see this with the transconjunctival surgery. You are missing soft tissue in the lower eyelid and orbital bone projection needed to support the lower eyelid. I have developed a surgery to repair these issues. I am appending a video of this work below. The good news is that there are powerful methods to help you achieve the look you desire. The important thing is not to use up any more resources along the road to getting the help you need. I advise a detailed personal consultation. Your eyes can be your best feature.

Johnson C. Lee, MD · Answer

Thank you for your photos. If you are still recently out from surgery (6 months or less) then it is best to wait to see how your skin will tighten and settle prior to any other interventions. If you are completed healing, then a simple fix will be to add hyaluronic acid filler to the area to blend the rim. The filler lasts a long time in that area and you will likely produce enough permanent collagen in the long run for lasting result. The additional volume and tissue support from the filler will also help restore a mm or so of height back to the lower lid to create more tilt. For more dramatic or instant results, you can consider additional fat grafting into the area as well as a canthopexy procedure to tighten the corner of your eye. I prefer to avoid implants in this areas as the edge of the implant can sometimes be visualized under the thin skin of the area and make the transition even more noticeable. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

How can I correct hollow between eye and orbital bone?

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How can I correct hollow between eye and orbital bone?

Answers (3)

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Our mission is to create a world where every investment in modern beauty is Worth It.