Infraorbital Rim Augmentation / 'Squint' look

[PloskoPlus]

I hate to be the first one to return to original topic, but has anyone here had orbital rim augmentation?  Or have examples?

I'm thinking about consulting with Dr. Yaremchuk about this as he is the only one with examples and specifically discusses this procedure.  Going in through the eyelid seems a bit risky, and I'm pretty sure that's the only option for this type of thing.

Can be done intra orally.  Eppley has an article on this. Eppley has an article on everything.

[Optimistic]

I hate to be the first one to return to original topic, but has anyone here had orbital rim augmentation?  Or have examples?

I'm thinking about consulting with Dr. Yaremchuk about this as he is the only one with examples and specifically discusses this procedure.  Going in through the eyelid seems a bit risky, and I'm pretty sure that's the only option for this type of thing.

Person above answered this, but eppley does it. He has articles on HA paste, various implant types.

Going in through the eyelid is easier, however intraoral is also possible.

[Gregor Samsa]

Eppley would probably make a fantastic professor with his knowledge but it feels like he does every plastic procedure under the sun so I can't imagine that he's good at even half of them since he doesn't get the benefit of specialization.

[Optimistic]

Eppley would probably make a fantastic professor with his knowledge but it feels like he does every plastic procedure under the sun so I can't imagine that he's good at even half of them since he doesn't get the benefit of specialization.

I was under the impression that Eppley has a good name for himself in the plastic surgery community. Unless I'm mistaken I'd be surprised if his work wasn't of a high standard.

Someone who's more into that 'scene' is welcome to correct me.

[geijutsu]

Eppley would probably make a fantastic professor with his knowledge but it feels like he does every plastic procedure under the sun so I can't imagine that he's good at even half of them since he doesn't get the benefit of specialization.

Epply does not write his articles. He has someone hired to do them for him.

I don't think he's highly regarded among his peers. I'm not saying he's at the bottom of the food chain either, but he isn't one of those docs who's considered "it" among his peers. He's just very good at self promotion.

[geijutsu]

I think aging is not a matter of bones or skin, it's bone, skin and everything in between: muscles, retaining ligamengs, fat. It's a multifactorial thing that experience aging as time goes by. My own obsevation also is that aside from the sagging issue, our faces lose fat in some places but gain them in others, changing the entire face shape with time. Grafting some fat in the places where it's been lost is not enough as there are some places where the fat hypertrophies such as the double chin. It's all one giant clusterf**k and our best bet is for us to slow it down as much as we could with nutrition, supps, lifestyle...etc because so far no doctor can make a 50 year old pass as a 20 year old, and judging from the path anti-aging plastic surgery is currently taking; I don't think it's happening anytime soon, either.

[earl25]

orbital rim deficiency imo is probably one of the hardest  things to fix. there are very few options out there. the only thing that's probably harder is a supra orbital rim deficiency or farhead issue.

I have only seen one eppley orbital rim implant result (atleast I think it was his, it was on his blog). it was ok

[jusken]

orbital rim deficiency imo is probably one of the hardest  things to fix. there are very few options out there. the only thing that's probably harder is a supra orbital rim deficiency or farhead issue.

I have only seen one eppley orbital rim implant result (atleast I think it was his, it was on his blog). it was ok

I've been doing a lot of research on this and have consulted with Eppley and Yaremchuk.  It seems like what makes an orbital rim deficiency such a difficult problem to fix is that, unlike jaw surgery, these doctors are essentially just eyeballing it.  Really, the closer one matches the target problem (using preformed implants), the better I suppose.  Atleast with jaw surgery you get to see your plan - they show you exact measurements and details.  Custom implants I don't know much about, but the cost is prohibitive for me.

I've come to the conclusion that there is only one preformed infraorbital rim implant that is worthwhile to pursue: the Medpor one Yaremchuk has shown on his website (can also be seen on the Stryker Medpor site).  Most surgeons seem to insist on using Silicone, yet this one only comes in Medpor.   I asked Eppley if there's any science to modifying (carving?) these to fit each case.  He said he does so on 90% of facial implants, but there is no science to it, just an 'artistic eye'.  But really, just eyeballing it and trimming it down?  Not sure how much confidence I have in its accuracy.

What's kinda depressing is that 3d printing technology could soon make custom models and implants very affordable.  I just don't see it happening in the next few years, which is when I'd like consider this procedure.

[PloskoPlus]

I've been doing a lot of research on this and have consulted with Eppley and Yaremchuk.  It seems like what makes an orbital rim deficiency such a difficult problem to fix is that, unlike jaw surgery, these doctors are essentially just eyeballing it.  Really, the closer one matches the target problem (using preformed implants), the better I suppose.  Atleast with jaw surgery you get to see your plan - they show you exact measurements and details.  Custom implants I don't know much about, but the cost is prohibitive for me.

I've come to the conclusion that there is only one preformed infraorbital rim implant that is worthwhile to pursue: the Medpor one Yaremchuk has shown on his website (can also be seen on the Stryker Medpor site).  Most surgeons seem to insist on using Silicone, yet this one only comes in Medpor.   I asked Eppley if there's any science to modifying (carving?) these to fit each case.  He said he does so on 90% of facial implants, but there is no science to it, just an 'artistic eye'.  But really, just eyeballing it and trimming it down?  Not sure how much confidence I have in its accuracy.

What's kinda depressing is that 3d printing technology could soon make custom models and implants very affordable.  I just don't see it happening in the next few years, which is when I'd like consider this procedure.

The non syndrome lefort iii paper I have says pretty much the same thing.  ( Ok, It's 20 years old, but still...) Cephalometric analysis does not apply... It's a judgement call.

[MrRochester]

orbital rim deficiency imo is probably one of the hardest  things to fix. there are very few options out there. the only thing that's probably harder is a supra orbital rim deficiency or farhead issue.

I have only seen one eppley orbital rim implant result (atleast I think it was his, it was on his blog). it was ok

I don't know about Eppley, but this Yaremchuk guy had a nice result although the scars to the side of the eye are pretty bad.




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[PloskoPlus]

I don't know about Eppley, but this Yaremchuk guy had a nice result although the scars to the side of the eye are pretty bad.

Great improvement in the eyes. But why scoop out his nose like that?

[Gregor Samsa]

There's no telling what those implants will look like in 10 years. Those scars are definitely not acceptable to me.

[earl25]

I don't know about Eppley, but this Yaremchuk guy had a nice result although the scars to the side of the eye are pretty bad.

this guy later ruined his face with fat grafts an dr y had to carve them out.

[earl25]

I've been doing a lot of research on this and have consulted with Eppley and Yaremchuk.  It seems like what makes an orbital rim deficiency such a difficult problem to fix is that, unlike jaw surgery, these doctors are essentially just eyeballing it.  Really, the closer one matches the target problem (using preformed implants), the better I suppose.  Atleast with jaw surgery you get to see your plan - they show you exact measurements and details.  Custom implants I don't know much about, but the cost is prohibitive for me.

I've come to the conclusion that there is only one preformed infraorbital rim implant that is worthwhile to pursue: the Medpor one Yaremchuk has shown on his website (can also be seen on the Stryker Medpor site).  Most surgeons seem to insist on using Silicone, yet this one only comes in Medpor.   I asked Eppley if there's any science to modifying (carving?) these to fit each case.  He said he does so on 90% of facial implants, but there is no science to it, just an 'artistic eye'.  But really, just eyeballing it and trimming it down?  Not sure how much confidence I have in its accuracy.

What's kinda depressing is that 3d printing technology could soon make custom models and implants very affordable.  I just don't see it happening in the next few years, which is when I'd like consider this procedure.

problem is its very hard to remove medpor. also the medpor implant is only like 2-3 mm so if u have a major deficiency it wont do much.

dr y now uses silicone covered in goretex

[earl25]

There's no telling what those implants will look like in 10 years. Those scars are definitely not acceptable to me.

very true. as you age an orbital rim implant will show