Are orbital rim implants required for solving scleral show?

Question

I’m interested in resolving a scleral show issue, but as I understand it, neither canthopexy nor canthoplasty solve the issue in their own. I have heard that an infraorbital rim implant is often used to support other operations. Is this an essential component? And what exactly is the full solution to scleral show? (I’m 25, and I’ve also heard it can be problematic in younger people to try and fix) Thanks!

C. Blake Perry, MD · Answer

Lower lid retraction can be treated in numerous ways depending on the cause. Most commonly in my practice, I treat lower lid retraction or scleral show with a lower lid spacer graft (hard palate or alloderm) and a canthoplasty. Orbital rim implants can certainly be used to help support the lower lid, especially if you have a negative vector (ie. the eye protrudes farther than your cheek bone). However, you need an in person consultation to determine the cause before a surgical plan can be made.

Barry L. Eppley, MD, DMD · Answer

The role of adding structural support to the infraorbital rim-anterior malar area can be an important component of getting the best scleral show improvement/lower eyelid repositioning particularly in patients with a negative orbital vector. It really comes down to is there any underling orbital rim deficiency. Many cases of lateral lower lid sag and excessive scleral show do have an underling skeletal  deficiency as the lower lid position usually follows the pattern of the bone shape underneath it.

Are orbital rim implants required for solving scleral show?

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Are orbital rim implants required for solving scleral show?

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Everything you need to know about Eyelid Surgery

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