Q: Dr. Eppley, I am in need of a special type of lower blepharoplasty. I had artefill injected under my eyes and have been having problems with it. Have you ever removed artefill in combinaion with a lower blepharoplasty before?
A: When it comes to lower eyelid procedures, I have seen may different materials placed in the lower eyelid tissues and along the bony orbital rims and orbital floor. I have removed in the past lumps of fat, clumps of artefill/artecoll, goretex strands and Medpor implants while doing lower blepharoplasties. Many of the particulated injections are often in the orbicularis muscles but because they are usually in clumps. Most of the material can be dissected out and removed as part of the lower blepharoplasty procedure. Your case illustrates the potential problems with using particulated fillers in the thin tissues of the lower eyelids. The appeal of a permanent filler is great but every particulated filler with non-resorbable particles has a great propensity for clumping and fibrosis.
Dr. Barry Eppley