Customized Infraorbital Rim Implant

Patients with relative deficiency of the lower orbital rim bone and cheek bone (“congenital maxillary hypoplasia") have appearance of sunken under eye area and cheeks with lack of malar projection, often with negative orbital vector anatomy with appearance of bulging eyes and sometimes with negative canthal tilt with sclera show and appearance of sad, tired eyes, which has occurred developmentally. These patients may benefit from customized infraorbital rim implant (extended tear trough implant) or customized infraorbital-malar silicone implant which helps create a more chiseled facial appearance or angular “model" look with high defined cheekbones with minimal under eye hollowness with more neutral or even positive orbital vector. Dr. Taban can also combine this with other procedures (as deemed necessary in one surgery) such as:

If necessary or desired, Dr. Taban can combine your implant with upper eyelid procedures such as upper eyelid ptosis surgery and upper eyelid filler injection (to reduce upper eyelid exposure with more hooded eyes) or perhaps it can be combined with upper blepharoplasty in patients wanting more upper eyelid exposure instead.

With a single, combined surgery, patients enjoy a more convenient and efficient experience. Whenever we can eliminate the need for multiple surgeries, that is a plus.

Each patient’s anatomy and desire are different, which means a custom treatment plan is critical for success. The procedure should fit the patient, not the other way around. Of course, beauty comes in different shapes and forms and the patient has to desire such changes. Every patient should consult with Dr. Taban to discuss their aesthetic goals, risks, and outcomes. You can read more about eye shape by following this link.

This video illustrates the important points regarding infraorbital rim silicone implant.

Infraorbital Rim Implant Technique

These are very specialized procedures that require extreme expertise. The eyes are very important and delicate parts of the face. The technique of orbital rim implant placement is critical in achieving safe and effective results.

Dr. Taban uses a scarless transconjunctival approach with the incision INSIDE, not outside, of the lower eyelids. This avoids damage to the eyelid function and eye shape, with much quicker healing.

Dr. Taban often treats complications (from other surgeons) who have performed this procedure with different techniques. These other techniques sometimes result in disastrous results such as lower eyelid retraction and scaring

Another major advantage of transconjunctival technique is that it can be combined with other procedures in one surgery (as deemed necessary) such as customized cosmetic orbital decompression surgery and/or lower eyelid retraction surgery with canthoplasty (almond eye surgery) for those wishing to change or enhance their eye shape while also seeking more defined facial/eye features and angularity; therefore it tremendously makes it more convenient and efficient and safer for the patient as it eliminates the need for multiple operations at different times (Buccal at removal can also be done concurrently in those who could benefit from it.).

Implant Type and Fixation

The type of infraorbital-malar implant and method of fixation are also very important. I only use solid silicone implant which is inert or nonreactive and I use fine sutures to fix it (with direct visualization via the eyelid). Solid silicone is permanent as it never has to be changed in the lifetime although it can be removed rather easily if desired as no tissues stick to it. Other implants such as Medpor have much higher risk of eyelid scarring and eyelid malposition; complications are even worsened if using metal screws for the fixation.

Male patient with congenital bulging eyes and lower eyelid retraction and significant under eye bone deficiency underwent cosmetic orbital decompression, lower eyelid retraction surgery, and lower orbital rim tear trough silicone implant (Infraorbital Rim Implant) placement.

Removal of lower orbital rim (tear trough) cheek medpor implant in a woman who was unhappy about its appearance. It was done using scarless inside eyelid approach. It’s removal was very difficult as medpor gets scarred to surrounding tissue. Silicone orbital rim implant would have been much easier to remove.

Video selfie of a happy transgender woman who underwent almond eye surgery with lower eyelid retraction surgery and canthoplasty, customized infraorbital rim silicone implant, customized orbital decompression, and upper eyelid filler.

Below you will see several examples of patients who underwent customized infraorbital rim silicone implant placement, often combined with other eye plastic procedures.

*See disclaimer below

27 year old transgender female, underwent eye transformation almond eye surgery including lower eyelid retraction surgery with canthoplasty, infraorbital rim silicone implant, orbital decompression bulging eye surgery, and upper eyelid filler injection. Before and 1 month after surgery photos are shown.
27 year old transgender female, underwent eye transformation almond eye surgery including lower eyelid retraction surgery with canthoplasty, infraorbital rim silicone implant, orbital decompression bulging eye surgery, and upper eyelid filler injection. Before and 1 month after surgery photos are shown.

Woman who was unhappy about her eye shape and eye asymmetry, underwent eye plastic surgery including cosmetic bulging eye orbital decompression, infraorbital rim silicone implant, lower eyelid retraction surgery with canthoplasty, right upper blepharoplasty and left upper eyelid filler injection. Note more almond shaped and symmetric eye appearance in the after photo taken 1 month after almond eye surgery.
Woman who was unhappy about her eye shape and eye asymmetry, underwent eye plastic surgery including cosmetic bulging eye orbital decompression, infraorbital rim silicone implant, lower eyelid retraction surgery with canthoplasty, right upper blepharoplasty and left upper eyelid filler injection. Note more almond shaped and symmetric eye appearance in the after photo taken 1 month after almond eye surgery.

Young man, complained of inherited lower eyelid retraction with sclera show and promiment eyes, underwent cosmetic orbital decompression plus lower eyelid retraction surgery plus orbital rim silicone implant. Before and 3 months after eye plastic surgery photos are shown. Note improved eye appearance in both front and profile views
Young man, complained of inherited lower eyelid retraction with sclera show and promiment eyes or negative orbital vector, underwent cosmetic orbital decompression plus lower eyelid retraction surgery plus orbital rim silicone implant. Before and 3 months after eye plastic surgery photos are shown. Note improved eye appearance in both front and profile views

Young Middle Eastern man, with congenital lower eyelid retraction and midface bony deficiency, underwent lower eyelid retraction surgery with canthoplasty and infraorbital silicone implant to create more almond shaped eyes.
Young Middle Eastern man, with congenital lower eyelid retraction and midface bony deficiency, underwent lower eyelid retraction surgery with canthoplasty and infraorbital silicone implant to create more almond shaped eyes.

Young Asian woman underwent cosmetic orbital decompression, infraorbital rim silicone implant, lower eyelid retraction surgery with canthoplasty and droopy upper eyelid ptosis surgery. Note more almond shaped eyes in after photos.
Young Asian woman underwent cosmetic orbital decompression, infraorbital rim silicone implant, lower eyelid retraction surgery with canthoplasty and droopy upper eyelid ptosis surgery. Note more almond shaped eyes in after photos.

Young Caucasian man underwent infraorbital silicone implant plus lower eyelid retraction surgery with canthoplasty (
Young Caucasian man underwent infraorbital silicone implant plus lower eyelid retraction surgery with canthoplasty (“almond eye surgery").

Before (left) young Middle-Eastern male with bulging eyes, lower eyelid retraction with sclera show, and sad eyes. 3 months after (right) he underwent cosmetic orbital decompression, lower eyelid retraction surgery, and canthoplasty to give more almond-shaped eyes.
Before (left) young Middle-Eastern male with bulging eyes, lower eyelid retraction with sclera show, and sad eyes. 3 months after (right) he underwent cosmetic orbital decompression, lower eyelid retraction surgery, and canthoplasty to give more almond-shaped eyes.

Contact the Los Angeles Oculoplastic Expert

Dr. Taban is one of the leading oculoplastic eye surgery doctors in the LA region. Contact us via online support form, or via telephone at: (310) 278-1836

Next, read about the lower blepharoplasty surgery.

*Disclaimer: Results vary from patient to patient. Results are not guaranteed.

Very natural look after quad blepharoplasty. Approaching my 50s I have decided to finally take care of my eye bags that have been bothering me for years. I have naturally heavy eyelids but with age the issue has become more and more visible. I live in Toronto and I have been scouting local plastic surgeons but I was not convinced by any of them and I was surprised by the high quotes I have received for a quad blepharoplasty. One of my goals was obviously to find a surgeon with lot of expertise in eyes surgery. So I have expanded my search to include the US and I finally picked Dr Taban. I had a first consultation by Skype and I was confident that he would be the right choice for me. … his approach seemed conservative enough and was meeting my expectations in term of keeping a natural look, without going too extreme to avoid hollow eyes or feminine look. I booked my surgery and flew to LA. The surgery was done with local anesthesia. … Surgery went well. The usual swelling and bruises but I was able to attend an important meeting exactly 9 days after the surgery without anyone noticing and with the help of a good concealer. Result is completely meeting my expectation. Natural, no visible scar, the shape of my eyes is intact, just a refreshed , bagless look. … I would definitely recommend Dr Taban to my friends and in fact I did. One of my close friend will get a quad done in a couple of months. Dr Taban is not extrovert but responded to all my questions and has very good bedside manners. He is also following up very quickly to questions by email. If you are looking for an eye specialist, Dr Taban is the right surgeon.

Elizabeth77



Elizabeth77
April 10, 2017

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