Malar/Infraorbital implant?

[kavan]

Kavan is spot on and doesn't get the credit deserved for this one.

The guy doesn't have bony recession of the inferior orbital rims: he has proper bony projection at the inferior orbital rims. What is bothering him about the tearthroughs, is likely a soft tissue issue. So filler/fat repositioning with/or very conservative fat transfer (difficult area: be CONSERVATIVE), may give him what he is searching for. He'd have to consult with an oculoplastic surgeon for that, to understand the exact soft tissue issue.
He has great bone structure, great jawline, but somehow wants to focus on a deficient bone structure he does not have. He's missing the main aesthetic issue if he's searching for an improvement: the nose. If he does not want to change that, you can't blame him: many horror stories out there after rhinoplasty. But to then go fix things that look good, may make him look ridiculous in the end.

Spot on. 'Don't fix what ain't broken' theory.

If he had bone recession there, he'd have the 'bug eyes' and scleral show from frontal which he doesn't have. An orbital rim guy might take him on if he fell in their lap asking for implants there. But all he has is some soft tissue hollowing superior to the orbital rim and the excessively wide lower half of the nose.

[Milli_Meters]

Bone support to his eyes, isn't his core problem. Excess nose width is.

People who focus and prioritize on things that are not the core aesthetic issue are either electing to ignore what others would be seeing on their face or are really ATTACHED to what ever their aesthetic detraction is. That's why I said he must be attached to the excess width of his nose.

As to 'feasible'; I think it's feasible to have some insight as to what the key detractor of the face is.

Duh. The first thing I told this guy was lefort 1 was a bad idea due to his nose width (among other reasons) Touching his nose though would be riskier than getting some soft/fatty filler type support under eyes.

[kavan]

Duh. The first thing I told this guy was lefort 1 was a bad idea due to his nose width (among other reasons) Touching his nose though would be riskier than getting some soft/fatty filler type support under eyes.

Well, lefort 1 (with an outward displacement) isn't indicated for him even if he didn't have a wide nose because he has excellent bi-max projection. So, the key preclusion for maxfax/bi-max is the excellent projection to the jaws he already has. NOT the width of his nose. So, don't 'dah' me.

Also, please don't assume a visual suggestion from me SHOWING him the key detractor from his face (wide lower 1/2 of nose) as an implied statement from me that rhino's don't have risks. I've given him a visual where he can choose to see or not see and explore further if the former.

As to any risks he might have, it would be his undue focus on problems he doesn't have . He doesn't have bone recession to his orbital rims as you have prior suggested to him, (ORIS). But you are making some progress in the observation department to note he could use some soft tissue filler under the eyes.

[PloskoPlus]

Bone support to his eyes, isn't his core problem. Excess nose width is.

People who focus and prioritize on things that are not the core aesthetic issue are either electing to ignore what others would be seeing on their face or are really ATTACHED to what ever their aesthetic detraction is. That's why I said he must be attached to the excess width of his nose.

As to 'feasible'; I think it's feasible to have some insight as to what the key detractor of the face is.

You're spot on... But I've never seen such narrowing. I believe it's impossible.

[kavan]

You're spot on... But I've never seen such narrowing. I believe it's impossible.

Well, I set it with reference to a vertical drop down from the inner canthi just to show the excess width to lower 1/2 of nose is the key issue. Not to predict a result.  But still, any narrowing he could get would be an improvement.

ETA:
I've seen it carried out before with similar noses. Takes a few rhinos, consecutively though but not really 'revision' rhinos and of course with docs conversant in what he has, . But I don't want to get into the minutia of rhinos, doctor suggestions, etc. just because I know his nose could be improved in the width department.