How Can I Treat My Undereye Hollows After Failed Fat Injections?

Q: Dr. Eppley, I would like to get information on corners of the mouth lift and under eye hollow implant procedures. I had a midface lift with fat transfer to the undereye hollows several years ago but it didn’t adequately solve the undereye hollows.

A:Under eye hollows can be successfully treated and there are five different ways to implant the infraorbital rim area. It all depends on how much ‘effort’ one wants to put into it and one’s feeling about a synthetic vs autologous approach. The midface lift with fat injections is a typical first line autologous approach but when that proves inadequate a different approach to volume correction is needed. Options includes onlay thick alloderm grafts, dermal-fat grafts, ePTFE sheeting and implants. (standard vs custom) Each of these has their advantages and disadvantages but since you have asked about implants I will focus on that topic. There are three types of so called undereye (infraorbital) implants, standard, custom and semi-custom. (made from my library of existing custom implant designs) I generally avoid standard infraorbital (tear trough) implants because they do not saddle the infraorbital rim…a key dimensional element in creating adequate undereye hollow correction. Such custom undereye hollow implants can have a wide variety of designs around the orbital-malar area based on the patient’s aesthetic needs. (see attached examples)

Dr. Barry Eppley

Indianapolis, Indiana