Will Custom Infraorbital Implants Solve My Undereye Hollows?

Q: Dr. Eppley, Hi, I had very hollow under eyes and underwent a lower bleph with fat repositioning but still not happy with my under eyes. I’ve looked into orbital rim implants and read on a forum from one of your past patients that he had orbital rim implants with you and it filled the hollow and lifted the lower lid slightly. This is exactly what I’m hoping for, it’s mostly the outer part of my under eye that is hollow and lacks projection and I’d like my lower lid lifted somewhat. I’ve attached some pictures that show what I’m hoping to improve. Thanks!

A:Thank you for your inquiry and sending your pictures. I would not have expected any efforts at lower eyelid fat transposition to solve under eye hollows. In an already fat deficient area simply moving what already exists is not going to provide any real volumetric improvement. You are correct in that infraorbital implants are the only method that can reliably improve the hollow undereye areas. But standard infraorbital implants (tear troughs) are not going to work as they only provide limited horizontal augmentation and not any vertical height increase which is the key in improving undereye hollows. This requires a custom infraorbital implant approach to address both the correct augmentation dimensions needed as well as have it fit your specific bony anatomy.

Dr. Barry Eppley

Indianapolis, Indiana