Infraorbital Rim Implants

Q: Dr. Eppley, Could you give me a bit more information on the infraorbital implants approach to undereye concerns? I’ve researched online and many sources state fillers/fat grafting as the best solution due to the high risk of asymmetry and unnatural appearance through implants. I’ve also heard that implants do not age well. Would these infraorbital implants also improve the appearance of my cheekbones (which are also relatively weak I think)? Thank you for your prompt and direct response.

A: In answer to your infraorbital implants questions:

1)None of the statements that you have read about infraorbital implants are accurate. They undoubtably come from providers who have either never performed infraorbital rim implants and only provide fillers/fat. The concept to grasp is that there are no true preformed infraorbital rim implants, only tear trough implants. Tear trough implants are not the same as infraorbital rim implants and are what surgeons may be only familiar. True infraorbital rim implants are custom made for each patient off of their 3D CT scan. Thus they fit the bone perfectly, have smooth transition into the surrounding bone, can be extended to augment the cheek as well (infraorbital-malar style) and actually elevate the level of the infraorbital rim. (standard tear trough implants only sit in front of the infraorbital rim and thus only augment it in the horizontal dimension…they do not cover the infraorbital rimin a smoother anatomic fashion and do not provide any height to the rim level)

2) In the treatment of infraorbital rim deficiency, the three treatments are synthetic injectable fillers, injected fat and implants. Each has their own advantages and disadvantages. But none of them are perfect nor is one method best for all patients. Each case must be considered separately and the magnitude of the defect considered in the treatment selection.

Dr. Barry Eppley

Indianapolis, Indiana