What Type Of Infraorbital Implant Works Best In Congenital Lid Retraction With A Negative Orbital Vector?

Q: Dr. Eppley, I’d be interested to know the approximate price of standard infraorbital rim implants and the price of custom ones as well. The lid retraction is genetic I’ve never had any surgery near my eyes. My goal would be to get rid of my sceleral show, improve my negative orbital vector and get rid of the darkness under my eyes.

A: It is important to be aware that standard infraorbital and custom Infraorbital implants do not have the exact dimensional effects. (customs saddle the rims while standard implants do not which will affect how they treat a specific problem particular in congenital scleral show)

While implants have a role to play in the treatment of scleral show and eye corner reshaping they must be combined with lateral canthoplasties and spacer grafts for the lower eyelids to be maximally effective. Natural scleral show is a reflection of underlying tissue deficiencies which includes bone and soft tissues. Unless all are addressed either a failed or inadequate result will occur. As a result you can see why the combination of implants (bone augmentation), spacer grafts (lower eyelid vertical tissue addition) and lateral canthoplasties (coner repositioning) is ideally needed.

Thus you have to look at implants as part of the solution but not the total solution.

Dr. Barry Eppley

World-Renowned Plastic Surgeon