Do Custom Infraorbital-Malar Implants Becomne Visible With Aging?

Q: Dr. Eppley, In considering Medpor infraorbital/malar implants for anterior cheek projection to achieve model-like high cheekbones. My concern is long-term: as facial fat atrophies and skin thins with age, do implant edges become visible or palpable by 50–60? I’d assume the infraorbital rim is the most vulnerable spot given how thin that skin already is.

Also — would a customized Medpor implant with tapered/feathered edges actually solve this, or does thinning tissue eventually reveal any implant regardless of edge design?

A: In the convex midface of the infraorbital – malar area implant edging is a critical feature that is needed to prevent both short and long-term implant visibility. In the event of midface,aging and soft tissue atrophy the issue of implant edging becomes even more critical. With this important implant consideration in mind. Medpor material  is not optimal as it does not have feathered edges, even when it is customized. It is milled from a block of material and that prevents the feather edging that is needed in soft tissue thin areas. The only material that works well in this area of the midface both short and long-term is solid silicone which can be manufactured with fine feathered edging.

Dr. Barry Eppley

Plastic Surgeon