Q: Dr. Eppley, why are tear trough implants such a rare procedure? Can the implants pop out of place? What are some bad things that could happen with tear through implants? I am very young with very dark eye circles and I look terrible and need to do something about it.
A: Tear trough implants are very uncommon because other simpler alternatives exist such as the use of temporary injectable fillers or fat injections. These are far more appealing to many patients, and in the appropriately selected lower eyelid defect, they can be a good and effective choice. At the least, an injection approach is a good trial to see if this more non-surgical approach can be effective. For a defnitive permanent solution to the lower eyelid tear trough/infraorbital rim deficiency, a bony-based implant can be an effective choice. Tear trough implants are placed through a lower eyelid incision. They are attached to the bone by small screws so there is no chance of them ever moving out of place. The only issues that I have ever seen with tear trough implants is that you may be able to feel them through the very thin lower eyelid skin. In addition, carving and shaping them down so they have a natural flow into the surrounding bone is important so that there are no unnatural step-offs is an important aesthetic contouring step.
Dr. Barry Eppley