Is a Fat Graft or Implant Better for the Correction of Enophthalmos?

Q: Dr. Eppley, I recently read something you wrote from this website Real Self on recommending an implant for the correction of enophthalmos. I was wondering if you could explain your preference over using an implant instead of fat. I was also wondering if you could clarify whether a risk of filling that area with an excess amount of fat could potentially cause proptosis. Thank you very much in advance.

A: Fat injections are less well uncontrolled in terms of placement and only have a soft push on the structures that need to the lifted. In addition how much volume do you need to correct the problem, over- or undercorrection is as likely as the right amount.  A custom orbital floor-rim implant is made from the patient’s 3D CT scan where the exact anatomic differences between the two sides can be determined down to the 0.2mm level. It is the best method of true skeletal correction if that is the goal.

But the treatment plan for each enophthalmos case must be determined on an individual basis.

Dr. Barry Eppley

Indianapolis, Indiana