Do Custom Infraorbital-Malar Implants Cause Chronic Eye Discomfort?

Q: Dr. Eppley, I’m considering custom infraorbital-malar implants to reshape my cheek and eye region. As part of that, I want to raise the level of the lower, outermost corner of my orbital rim by around 1mm; my goal is to slightly raise the outer portion of my eyelid. However, I’ve heard that raising the orbital rim could cause persistent discomfort that might only be resolved by removing the implants. Several questions: 1. How likely is this discomfort? Are there any ways to mitigate the risk? 2. Is it reasonable to use infraorbital-malar implants for minor eyelid shape adjustments like this?

A: In answer to your Infraorbital-malar implant questions:

1) The discomfort to which you refer is something I have never seen or been reported by any patient. Having done hundreds of pairs of custom infraorbital and infraorbital-malar implants that is a postoperative problem I have yet encountered. I don’t know the basis of where you heard of such a problem but there would be no anatomic basis for it.

2) Many patients that pursue 3D infraorbital rim augmentation do so with one of the intents is for improved lower lid positioning.

Dr. Barry Eppley

World-Renowned Plastic Surgeon