Is the Eyelid or Intraoral Approach Better For Placing Cheek Implants?

Q: Dr. Eppley, I did more research and noticed that sometimes you use an incision under the eye instead for cheek implants. Myquestions are: 

1) Which approach is more likely to get a symmetrical result?

2) What are the biggest risks of going through the eye lid?

3) Lastly, what is the recovery like when going through the eyelid? 

Sorry for all the questions, but I’m very interested in the eyelid approach in order to virtually eradicate the chance of infection. 

A: The incisions used for surgical placement depend on the actual design of the implant. But if the implant has a significant infraorbital component that saddles the bony rim then a lower eyelid incision is used for its placement. This is also helpful if the zygomatic arch component is very long and extends back to the zygmatico-temporal suture line.

The biggest risk in going through the lower eyelid, like any lower eyelid surgery for any reason, is ectropion or see slight malposition of the corner of the eyelid. But this is very uncommon in young patients who are not having an excisional procedure and the incision is used only for access.

Like all facial implant surgeries the initial swelling will be significant and will take a few weeks to become less disturbing…although the complete facial recovery is a 6 to 8 week process.

Dr. Barry Eppley

Indianapolis, Indiana