Are Custom Infraorbital Rim Implants Better In My Case Than Standard Infraorbital Rim Implants?

Q: Dr. Eppley, I have seen you are well qualified in the realm of orbital implants. I have also noticed that you use custom infraorbital rim implants over standard Medpor infraorbitals or Implantech tear trough implants — your proposal being that these custom implants saddle the infraorbital rim and increase vertical height whereas standards do not. 

I am intending to get both infraorbital implants to increase horizontal cheek projection, as well as have lower eyelid repair (canthoplasty and graft). What is the benefit to this vertical heightening and customisability of the custom implants in my case? Wouldn’t a standard implant suffice considering my goal is horizontal projection and support to the lower lid through use of a graft? (I’ve heard the increase in vertical height helps support the lower lid, but given I’m also having the other procedure, I didn’t know if it was relevant in my case). 

I would be very grateful if you could answer my question, Many thanks and kind regards

A: Any time you can add vertical height to the infraorbital rim it has a synergestic effect with lower eyelid repair…which I assume the goal is to elevate the rounded/sagging eyelid. If one of the contributing causes to the shape of the lower eyelid is the shape of the rim (there is a linear relationship between the shape of the lower eyelid and that of the underlying bone which supports it), then a 3D bony approach is superior to a 2D one.

Dr. Barry Eppley

World Renowned Plastic Surgeon