Filler Options for Under Eye Hollow Related to Prosthesis? (photo)

I'm exploring options to improve the look of my left eye. I was born with microphthalmia and have worn a series of scleral shells since infancy. I am happy with my current shell, which fits well and was crafted using digital iris-matching technology by a well regarded ocularist in CA. I've had a brow lift, and would like to address the deep under-eye trough. I've been advised that fat grafting is a good option for even, long-term results. What are related risks, costs, and recovery times? I'm 29.

Doctor Answers 2

There are multiple solutions for optimizing the appearance of an ocular prosethetic

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1. Your photos show a socket that is relatively volume deficient, causing the prosthetic to ride a little low and laterally.  You should connect with an oculoplastic surgeon to discuss your orbital volume situation and consider further orbital volume expansion.  This will likely be insurance covered.

2. Your photo also demonstrates ptosis on the right side.  This can be corrected via an incision that is hiddern behind the eyelid.  This would provide you with improved symmetry and would likely be insurance covered.

3. Your lower eyelid bows downwards.  This is also a result of volume deficiency of the orbit, but can be camouflaged with volume- dermal grafting to the lower eyelid or fat transfer.  Again, since this is a reconstructive situation, you should likely get insurance coverage for the asymmetry.

Bottom line: meet with an experienced oculoplastic surgeon that does both anophthalmic reconstructive surgery as well as cosmetic facial surgery to create your best possible action plan. 

Good luck!

Austin Oculoplastic Surgeon

Under eye hollow correction

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Fat works fine as does Juvederm.  These are your best options.  Fat success is quite good in 2013.  Juvederm is very easy.   Juvederm is less costly.  For a simple improvement use Juvederm.  When you have time for surgery do fat.

My Best,  Dr C

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