Is My Infraorbital Rim Implants Causing A Bulge Under My Eye?
Q: Dr. Eppley, about 4 years ago upon a surgeons recommendation, I got infraorbital implants. Shortly afterward, I noticed a “bulge” underneath my eyes. I am not sure if the implants need to be removed or if this is a case of my cheeks dropping and my own bones would have produced the same appearance. I believe the implants were placed close to the lower lid. (I have attached a picture of where they are placed ) I am not sure exactly what they are made out of. When I went to the web-site, it just said a porous material. I believe that they were placed from inside the mouth.
A: Based on that information, you have Medpor implants placed through the mouth. This means they are actually a combined infraorbital rim/malar type implant. The bulge to which you refer, given that it appeared shortly after surgery, is undoubtably that of the implant and not your natural bone. As the tissues eventually contract and shrink around the implants, their outline and placement become fully evident.
The good question now is what to do with them. The only way to get rid of the bulge is to remove the implants. The interesting question is what will happen to the soft tissues that have been expanded because of them. It may be that is largely a non-issue or it may be that it will cause some soft tissue sagging over the cheek afterwards. It is hard for me to tell the likelihood of either just based on one single photo. However, knowing their location, size (bulge) and that they are a Medpor material (which means they will be harder to remove), that all suggests that there may be some additional cheek sagging afterwards. An alternative approach to removal is to feather the edges of the implant so that a bulge no longer is seen, but keeping the implant volume in place.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.