Which surgery is best for deep orbital rims?


I am 23 and I have deep orbital rims.  I tried Restylane many times and although it looked amazing, it went back to looking the same after a week. I  heard orbital rim implants are too risky and can cause infection. Which surgery is best?




 Thank you for this great question. Recent advancements have allowed for very successful fat grafting to this area. It produces a permanent result. We commonly combine fat grafting with almost all of our face lift patients. To give you an idea of what can be done here is a link. Please look under MACS Face Lifts/ Fat Grafting ( http://garyculbertson.com/facial-plastic-surgery-before-and-after/ ). If this is the kind of result you are looking for in the perioccular area consider a member of the ASAPS in your area. Best,


Gary R Culbertson, MD, FACS


If Restylane worked well to fill under eye hollows but did not last, then fat grafting of the area should work well and, though it may take more than one sessions, should be permanent. This generally works better than an implant. Make sure whomever you see for this has plenty of experience.


A.: Since you achieved a good cosmetic result with Restylane, but it wasn’t long lasting, a more permanent improvement can often be achieved with micro fat grafting performed in an artistic and meticulous manner. Generally, in the orbital rim area 50-70% of the fat remains permanently. An occasional patient may benefit from a second procedure to further improve the results. Implants in this area have a greater potential for short and long term problems.

Keep in mind that following the advice of anyone on this or any website who would presume to tell you what to do without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD  FACS

La Jolla, California

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