Why Do So Few Surgeons Perform Custom Infraorbital Implants With A Saddle?
Q: Dr. Eppley, In regards to the saddle infraorbital implant, I am just wondering, is there any risks associated with the saddle? Like the edge of the orbital bone eroding, or just general safety issues associated with silicone entering the eye socket?
Also, is this implant commonly requested for? So few surgeons do this implant world wide and it surprises me considering how great of an aesthetic boost it gives. It’s seems even better than procedures like canthoplasties which tend to give uncanny results in comparison. I’m puzzled why this isn’t more popular.
Thank you for your time.
A: In regards to your questions in regards to custom infraorbital or infraorbital-malar implants:
1) I have never seen any evidence of implant bone settling (what is often erroneously called bone erosion) clinically or on 3D CT scans. Nor would I expect it in an implantation site that does not a have a tight muscularized soft tissue cover.
2) These custom implants are for aesthetic conditions that are associated with various degrees of orbito-zygomatic skeletal underdevelopments or retrusions. These are externally seen in various clinical conditions such as lower eyelid sag with scleral show, undereye hollows, negative orbital vectors, flat cheeks and overall midface retrusions.
3) The development of any surgical technique first begins with awareness followed by acceptance which then leads to common use.
Dr. Barry Eppley