Orbital rim implants are usually made from either medical grade silicone , from medpor or from PEEK, all materials have been commonly and successfully used in surgery form many years The implants are designed to fit directly onto orbital rim and are usually preshaped. Custom made implants can be obtained, if wished or considered necessary, although a CT scan of the bony structures is required before these can be constructed.
Non-surgical alternatives include the use of facial fillers, which are usually temporary.
Surgical alternatives to cheekbone implants are either:
– On lay bone graft, this requires bone to be harvested from another site (commonly the hip or the skull).
Orbital rim implant placement is usually undertaken as a day case procedure under a general anaesthetic. Access to the orbital rim is either made through an incision under the eyelashes ( a subciliary incision) or via an incision inside the lower eyelid, which isa known as a transconjuctival incision. In both cases the incision has to extend slightly out at the side of the eyelid which will leave a small but well hidden scar. The implants are placed directly onto the bone of the orbital rim and secured with 1-2 small titanium screws to prevent any movement of the implants following placement. The wound is closed with very small stitches.
Following surgery you can expect some soreness and some swelling. The initial swelling and bruising will settle over 10-14 days; however it will take a number of weeks for the swelling to finally settle and the new appearance to take shape.
Initially following the surgery you can expect soreness, bruising, swelling and tightness. This will settle with time.
There will be a small scar beneath the lower eyelashes, this usually heals quickly. There can occasionally be some slight pulling down (ectropian) of the lower eyelid during the initial healing period.
Other complications are unlikely but include, bleeding, infection, facial asymmetry, numbness of the skin of the cheek and upper lip, which is usually temporary but can take a few weeks to fully settle.
Any surgery around the eyelid area carries a very small risk to vision.
Implant infection may mean the implant needs removal. If this occurs then you will need to wait until the tissues have healed before having another one placed.
It may be possible to palpate the edge of the implant under the skin if you have thin skin; however the edges are not likely to be visible.
You will be given a short course of oral antibiotics to be taken following the surgery and the course should be completed.
Bruising and swelling is normal and to be expected, the swelling will reach its worst at 3-4 days following the surgery and then gradually settle over the next week. Ice packs can help reduce this.
Sleep on 3-4 pillows at night as this will help reduce the swelling.
I would advise 2 weeks off work following this surgery and you should avoid any strenuous sports for 4-6 weeks. Gentle exercising can be resumed 3-4 weeks after surgery.
You will be seen in clinic for follow up, one week, 8 weeks and 6 months following the surgery.