Orbital Rim Implants

Q: Dr. Eppley, I am seriously considering having orbital rim implants and submalar implants done by you. I have deficiency in the under eye and lower cheek area and would like them filled out. I regularly read your blog and see that you can create custom infraorbital and cheek implants. Do you think it is necessary to go the custom route or can you still get good results with off the shelf implants ( especially orbital implants). Also, could a custom implant be created that covers the infraorbital area and also goes all the way down to below the cheek to the submalar by a once piece implant?

A:Good to hear from you again. As you may recall we have communicated in the past and I have all of your pictures for reference. The fundamental question you are asking is whether using standard orbital rim implants (tear trough)  and submalar implants would produce a similar result as that of a custom orbital rim-submalar implant. The answer is probably not the same aesthetic result because the two areas would spill not be connected while the underlying bone (albeit deficient is) The other way to answer that question is which is least likely to have other potential aesthetic complications (asymmetry, implant malposition) to which that answer is more obvious. When you have two single piece custom  implants (orbital rim-suibmalar implants) versus four standard implants that are not connected which is superior is that regard is much more obvious.

Dr. Barry Eppley
Indianapolis, Indiana