Why Are Custom Infraorbital Implants Not Done More Frequently?

Q: Dr. Eppley, I have a question regarding infraorbital rim implants. I recently asked an oculoplastic plastic surgeon whether custom implants can be used to augment under eye hollows. He said he used them for reconstructive cases, but the results never looked “normal,” and he would “never recommend it for cosmetic reasons.” I’m aware that you disagree, but I’m curious to know why this procedure is so controversial in the medical community compared to other procedures such as a rhinoplasty. Is it simply ignorance on the part of many doctors who have not performed this procedure or who rely on outdated techniques? This procedure is something I’m interested in, but the lack of information, as well as before-and-after photos online (especially of young patients like myself), makes it difficult to be assured of its effectiveness as well as what sort of an outcome can be reasonably expected. 

A: I can not speak to other doctor’s experiences or the basis for their comments. A good general rule that I have learned when listening to any surgeon’s opinions on a topic is….have you actually done the specific procedure in question and, if so, how many times? In other words what is the basis for this supposed learned opinion. 

I believe on the topic of custom infraorbital rim implant techniques you have likely hit on exactly the reasons for any strong onions against them….lack of any experience in doing them and relying on non-contemporary techniques. Using 3D design technology and custom making any infraorbital or infraorbital-malar implant, it would be very hard to replicate the fit and the result that it creates any other way.

There is a very specific reason you will find few before and after pictures of young makes who have had the procedure….these are exactly the patients who almost never want their pictures shown. And I would this would likely apply to you as well. Not many young male patients agree to have pictures posted across the internet that show their eyes…which is impossible to do with infraorbital implants.

Dr. Barry Eppley

Indianapolis, Indiana