If I Fix My Negative Orbital Vector Will I Need Paranasal Implants?

Q: Dr. Eppley, I’m looking to correct a negative orbital vector and lack of anterior projection and what I suspect is a lack of anterior projection of my cheeks. I understand that in other cases such as these you’ve recommended custom infraorbital malar implants. I would also like to know if paranasal implants would be appropriate for improving my nasolabial area. I would be interested to know your opinion on what the most appropriate course of action would be. Thanks!

A: As you have correctly surmised you have a lack of midface projection which is a major cause of the appearance of your under eye area.  When you have a negative orbital vector by definition it is not limited to just the infraorbital area but includes the cheeks as well. Because it is a generalized lack of midface development there certainly is an argument for paranasal augmentation as well. Many times when you augment the infraorbital-malar areas then the central lower midface deficiency becomes more pronounced.

Dr. Barry Eppley

Plastic Surgeon