How Is The Thin Lower Eyelid Tissues Thickened After Undereye Implant Removal?

Q: Dr. Eppley, After under eye implant removal, is it possible for there to be soft tissue/fat loss under the eye? After mine were removed I noticed extreme hollowing where I can feel the bone right below my eyelid. There is little to no soft tissue there. 

Also, when operation on patients who have previously had implants, is the soft tissue reattached to the bone, or after implants will it float over the bone and never reattach? 

Lastly, is there any minor procedure to tighten the soft tissue after implant removal, such as skin pinch? A subperiostial dissection scares me after my negative experience. 

Thank you 

A: By definition any facial implant placement requires soft tissue detachment which then floats on top of the implant. When the implant is removed, unless the tissues are elevated and resecured from whence they came, they will ‘fall downward’ over the orbital rim making the tissue over the rim thinner. Short of resuspending those fallen soft tissue, there are no other effective procedures. No form of a lower eyelid skin removal is going to create that lifting/tissue thickening effect.

Dr. Barry Eppley

Indianapolis, Indiana