Wil An Infraorbital Rim Implant Help Fix My Lower Eyelids Which Are Pulled Down?

Q: Dr. Eppley, I have had eyelid surgery before. I had festoons so to get rid of them the Dr. pulled my lower eyelids and now they bow. I look Asian now. I would like to put in an orbital rim implant and small lower cheek implant. I also have one eye that looks closed and i am not sure if because pulling on lower is forcing upper down. My questions are:

1) Can we add a orbital implant under eyes plus lower cheek bone implant to add fullness because I look caved in?

2) Can you make me look less Chinese and have an eye shape like I had before?

3) Can you work on upper lid so it doesn’t look like my eye is closing and maybe work on one or both upper lids? I have big scars and hopefully can reduce scars??? After surgeries and healing occurs can have scar reduction surgery???

A: Thank you for your inquiry and describing your eyelid concerns. By your description you had an aggressive lower eyelid procedure in an effort to ‘lift out’ the festoons. (which is very prone to lower eyelid ectropion problems) The bowing down is the rounding of the lower eyelids due to loss of vertical height. The upper eyelid issue is a bit unclear to me. But I will need to see pictures of your eye area to provide a more qualified opinion. Until then I can answer your questions as follows:

1) An infraorbital rim-malar combined implant can treat the caved in look which is the result of inadequate volume.

2) To get your eyes back to normal and less deformed, it will require a combination of #1 and lower eyelid reconstruction with spacer grafts for the lower lids and lateral canthopexy.

3) I am as yet unclear about your upper eyelids so I shall wait to comment until I have seen pictures of them.

Dr. Barry Eppley

Indianapolis, Indiana