Can A Standard Infraorbital Rim Implant Just Be Raised Up To Provide Infraorbital Rim Height?

Q: Dr. Eppley, I am looking to get an implant of the style provided by the picture that I have attached. (Medpor lateral and infraorbital rim implant) I have two questions about this kind of implant: 

1) Is it possible to maneuver this implant to sit higher up on the face? You’ve made comments before about elevating the infraorbital rim with implants, is it possible to just shift an implant like this upwards; and then screw it in place, in the same fashion as is done with a custom implant? 

2) Is it possible to actually fine-tune the shape of an implant like this by shaving certain parts in order to give more fullness in a particular area? 


A: I believe the framework of your question is whether to avoid making a true custom infraorbital implant can this preformed Medpor implant be used instead. The answer is yes with the following caveats:

1) There will be irregularities at certain points as no matter how it is carved it is impossible to adapt it perfectly to your own bony anatomy. This is not a very easy material to hand carve as it is very rigid plastic. The thin tissues of the eyelid is very aesthetically unforgiving for an irrgularities..

2) Because of its rigidity, a larger lower eyelid incision is needed to place them than with other materials.

3) Should a revision be needed be aware of the traumatic nature of its removal due to the tissue adhesion.

4) Given the high risk of irregularities around the eye area I would be very cautious about trying to ask any preformed implant to do too much. This is what custom designed implants do better.

Dr. Barry Eppley

Indianapolis, Indiana