Tear Trough Implants

Q: Dr. Eppley, I am interested in getting tear trough implants. Whenever you have the time, I wrote down a few questions for you:

-In regards to affecting vision when working in the lower eye area, my understanding is that there have been issues with injectable fillers/fat injections very rarely being injecting into veins and causing an retinal artery occlusion.  Since this is an implant, is it safe to assume this is not an issue to be concerned with, and that vision will not be affected?  Is there a concern with the pressure of the implant against veins or nerves in the lower eyelid area?

-I have some reservations about doing an eyelid incision, would tear trough implants or submalar implants be able to be inserted through the mouth as an alternative to improve the upper cheek area/lower eyelid area? 

-Is there irritation in the eye area during the recovery time for the eyelid incision?

-Is the implant shown made from silicone? I would prefer to use that material rather than Med-por since I already have silicone used for the skull implants and seem to be doing very well with those.

-Are there medical complications if I ever decide to have the implant removed?
A: In answer to your tear trough implants questions:

1) Placement of infraorbital rim-malar implants does not affect vision or poses any risk to it. There is also no issues with adverse pressure on any neurovascular structures in the area.

2) You can placed infraorbital-malar implants through the mouth but there is a higher risk of implant malposition and there would be some protracted numbness of the lip and nose because of traction on the infraorbital nerve. These potential issues are mitigated when going through lower eyelid incisions.

3) These would be silicone implants.

4) There are no medical complications from removing such implants later if so desired. In fact they are less traumatic to remove than they are to place.

Dr. Barry Eppley
Indianapolis, Indiana