Can infraorbital rim implants become visible through the skin after aging? (Photo)

Surgeons are overly optimist about the acceptability of these implants. Yes, especially in a thin eyelid like yours, the contour of the implant can be visible. This is worse when the surgery permanently damages the motor nerve that supply the muscle in this area. Prior to the development of the hyaluronic acid fillers, the implant was our only option for this area. Also be aware that the other option is grafted fat. Again there are many are unhappy with grafted fat. In particular, when you gain weight, the grafted fat gains weight. Now, here is the down side to hyaluronic acid fillers. Placement of these products is fussy. Not all of the fillers are right for this area. The best product for this area is the filler Restylane. It is high G prime so it tends to stay put but unless carefully sculpted, it can form lumps and bumps. The so-called smooth fillers have a low G prime and actually drift after placement. These products tend to migrate down the cheek. Finding a skilled injector to place Restylane at the orbital rim is very challenging. The good news is that an injectable enzyme can removed unsatisfactory filler as an office service.

With significant infraorbital rim recession, infraorbital rim augmentation would be appropriate. But you would want to stay away from standard implants because they are not made to your specific anatomy and do not raise the height of the rim which also the dimension you need. Because of these two issues you are correct in that they may become visible over time. Custom made infraorbital rim implants would be superior because they would fit your bone better and would flow more smoothly into the surrounding bones substantially decreasing the risk of implant show later.

There are very good reasons that fillers have almost completely replaced orbital rim implants. First, even if you can customize the implants, the area around them continues to change making them not fit after a while. Even if you customize the implant, it is hard to get it to fit properly. One advantage of fillers is that they can correct any problem an implant can more precisely. By adding at a later time they can account for any changes in the tissues over time. Another consideration is that the new fillers for this area like Juvederm Voluma are lasting significantly. I have had it last over 5 years in this area.