Are Infraorbital Rim Implants The Correct Treatment For My Undereye Hollows?

Q: Dr. Eppley, Hello! I have been searching extensively for a plastic surgery solution to my deep dark circle/hollow tear trough problem since i was young. I do not desire fillers or fat transfer because of the impermanence and unpredictability of the procedures respectively. I came across infraorbital rim implants which seem to have a beautiful and permanent aesthetic outcome. I was told by a dermatologist that the source of my deformity was a lack of sufficient bone structure around the eye region rather than tissue loss/migration. I had my own theory that an abnormally connected orbitomalar ligament also plays a role, where release may be necessary to correct the depth of the indentation. I read about the type 2 implant mentioned on your website and thought it would be perfect for me as it could fill my under eye area as well as give me a more chiseled cheekbone projection. Please let me know if this would be suitable or if something else could be done better. I’ve attached a photo for reference. Thank you very much

A: Anytime deep undereye hollows exist, tear troughs and rounded lower eyelids are present, there is an underlying bony deficiency. Thus infraorbital rim augmentation is needed. The only debate is in whether a standard style 2 infraorbital implants is adequate to whether custom infraorbital-malar implant which straddles the rim and added both vertical height as well horizontal rim projection would be better.

In placing infraorbital implants off any size or style it is always necessary to release numerous ligaments along the orbital rim from the tera trough ligaments out to some of the orbitomalar ligaments. (of which there are numerous ones)

Dr. Barry Eppley

World Renowned Plastic Surgeon