I need advice on how to fix my extremely bad eye area

[MoostWestThuisBest]

I know I have droopy eyelids and negative canthal tilt. I will fix those if i get enough money.

What I could fix right now and bothers me the most is my under eye hollows. Theres just nothing there no bone no fat nothing.
I am considering tear trough fillers, but I read somewhere that maybe cheek fillers would be better.
What do you guys think?

Also what is the cause? I thought my maxilla was recessed, but I have had lower jaw surgery some years ago and the doctor said my maxilla was fine. Is it just recessed orbitals or no cheekbone prominence?

the pictures:

 

[Artemis]

I know I have droopy eyelids and negative canthal tilt. I will fix those if i get enough money.

What I could fix right now and bothers me the most is my under eye hollows. Theres just nothing there no bone no fat nothing.
I am considering tear trough fillers, but I read somewhere that maybe cheek fillers would be better.
What do you guys think?

Also what is the cause? I thought my maxilla was recessed, but I have had lower jaw surgery some years ago and the doctor said my maxilla was fine. Is it just recessed orbitals or no cheekbone prominence?

the pictures:

I fixed this with cheek filler + tear-trough fillers. The amount was 1 cc for the cheek, and 0.5 cc for the tear-trough.

 

[Deleted member 23399]

Recessed orbitals are often caused by lack of cheekbones. You have decent lateral zygo growth and a decent maxilla even but poor undereye support probably because of infraorbital genetics.

From the side view, your orbital vector isn't even that bad either. Just try using some concealer but if u insist, go for tear trough filler as cheek filler erodes far faster and more prone to migration

 

[Artemis]

Recessed orbitals are often caused by lack of cheekbones. You have decent lateral zygo growth and a decent maxilla even but poor undereye support probably because of infraorbital genetics.

His orbital rim is just recessed. It means 2 things:

1) Upper maxilla recessed
2) Anterior cheekbone is recessed

If any of these were not true, he would not have this.

 

[Deleted member 25339]

His orbital rim is just recessed. It means 2 things:

1) Upper maxilla recessed
2) Anterior cheekbone is recessed

If any of these were not true, he would not have this.

How do u go about assessing this without a cephalogram?

 

[MoostWestThuisBest]

I fixed this with cheek filler + tear-trough fillers. The amount was 1 cc for the cheek, and 0.5 cc for the tear-trough.

could i see your results? in dm if you want

 

[Artemis]

How do u go about assessing this without a cephalogram?

It is visible without any CT. There is literally a hollow where his orbital rim should poke through. Aka negative orbital vector.

And orbital rim is two bones: maxilla (inner orbital) and cheekbone (outer orbital). His looks totally absent. Both parts.

 

[MoostWestThuisBest]

Recessed orbitals are often caused by lack of cheekbones. You have decent lateral zygo growth and a decent maxilla even but poor undereye support probably because of infraorbital genetics.

From the side view, your orbital vector isn't even that bad either. Just try using some concealer but if u insist, go for tear trough filler as cheek filler erodes far faster and more prone to migration

Thanks! What do you think of infraorbital or infra malar implants? or are fillers a better option

 

[MoostWestThuisBest]

His orbital rim is just recessed. It means 2 things:

1) Upper maxilla recessed
2) Anterior cheekbone is recessed

If any of these were not true, he would not have this.

do you know what surgeries could fix those?

 

[Deleted member 25339]

Op you chin mog me but your orbital vector is way more brutal than mine and mine is death tier fix it asap

 

[Deleted member 23399]

Thanks! What do you think of infraorbital or infra malar implants? or are fillers a better option

yeah as Artemis said your infra rims are recessed. Filler is good for the short term while you save up for infra implants. I'm probably gonna get infra implants too few years from now after I lose volume under eyes

 

[MoostWestThuisBest]

Op you chin mog me but your orbital vector is way more brutal than mine and mine is death tier fix it asap

eye area is much more important than chin man youre lucky. What do you suggest i do to fix it?

 

[MoostWestThuisBest]

yeah as Artemis said your infra rims are recessed. Filler is good for the short term while you save up for infra implants. I'm probably gonna get infra implants too few years from now after I lose volume under eyes

with infra implants do you mean orbital or malar? In the mean time I will try tear trough fillers

 

[Deleted member 25339]

eye area is much more important than chin man youre lucky. What do you suggest i do to fix it?

Ask @Artemis he's more experienced in eye area but I'd say tear trough fillers, concealer and if you're prepared for surgery infra implants would be good to imo

 

[Artemis]

could i see your results? in dm if you want

DM me

do you know what surgeries could fix those?

Filler. Do both cheek and inner portion of the rim.

If you like the results, you can do infra + cheek implants but this is expensive. Otherwise, fat transfer is even better but it is very dangerous and unpredictable.

Finally, midface lift fixes this, but it has a risk to look unnatural.

 

[Deleted member 15866]

yeah as Artemis said your infra rims are recessed. Filler is good for the short term while you save up for infra implants. I'm probably gonna get infra implants too few years from now after I lose volume under eyes

yeah tbh. infraorbital implants with saddle is the way to go if you have shitty under eye support.

 

[Artemis]

yeah tbh. infraorbital implants with saddle is the way to go if you have shitty under eye support.

TBH, i think i learned that saddle infraorbitals are a scam...

It seems like guys e.g. Taban can take an off-the-shelf implant, and simply stick it in such a way, that its upper border projects above the orbital rim. And no need to pay 15k for the custom stuff. Implantech extended tear-troughs probably cost 1k max...

 

[Deleted member 15866]

TBH, i think i learned that saddle infraorbitals are a scam...

It seems like guys e.g. Taban can take an off-the-shelf implant, and simply stick it in such a way, that its upper border projects above the orbital rim. And no need to pay 15k for the custom stuff. Implantech extended tear-troughs probably cost 1k max...

So you are saying off the shelf implants produce outcomes almost good as custom ones because a custom design isnt that a special thing for infra implants?

 

[Artemis]

So you are saying off the shelf implants produce outcomes almost good as custom ones because a custom design isnt that a special thing for infra implants?

Yeah, it produces the same result: changing the geometry of the lower eyelid by making the orbitals more compact.

As for how well "custom implant" adheres to the bone in comparison to the off-the-shelf one, i don't know. Theoretically customs should always be better. BUT effectively, the results they achieve will be almost the same, except the customs cost more.

Also, OP does not need saddles, unless he wants to change his lower eyelid. He wants to remove the hollows under eyes. This is done with a traditional tear-trough iplamnt or even cheek implant without full rim. Sth like Ramieri does.

So, all the way...

@MoostWestThuisBest you might want this ^

 

[MoostWestThuisBest]

Yeah, it produces the same result: changing the geometry of the lower eyelid by making the orbitals more compact.

As for how well "custom implant" adheres to the bone in comparison to the off-the-shelf one, i don't know. Theoretically customs should always be better. BUT effectively, the results they achieve will be almost the same, except the customs cost more.

Also, OP does not need saddles, unless he wants to change his lower eyelid. He wants to remove the hollows under eyes. This is done with a traditional tear-trough iplamnt or even cheek implant without full rim. Sth like Ramieri does.

So, all the way...

@MoostWestThuisBest you might want this ^

Thanks a lot. I do want to fix my under eyelids as theyre too droopy and i have pretty bad scleral show. Would you suggest tear trough implant + saddle for that then? I dont really know what the saddle does. Also maybe lower lid retraction surgery would be better?

 

[Deleted member 15866]

Yeah, it produces the same result: changing the geometry of the lower eyelid by making the orbitals more compact.

As for how well "custom implant" adheres to the bone in comparison to the off-the-shelf one, i don't know. Theoretically customs should always be better. BUT effectively, the results they achieve will be almost the same, except the customs cost more.

Also, OP does not need saddles, unless he wants to change his lower eyelid. He wants to remove the hollows under eyes. This is done with a traditional tear-trough iplamnt or even cheek implant without full rim. Sth like Ramieri does.

So, all the way...

@MoostWestThuisBest you might want this ^

tbh custom infra implants sounded odd to me too.

Custom definetly matters but if you dont have the bucks and just want to fix your shitty undereye support, i guess you will still get your shit done if you get an off the shelf one and you definietly wont be bothced since infras are just a supporting tissue, not a main feature like jaw, chin...

But this is not the case with chin and gonion implants most of time.

But are you sure that patients who get off the shelf implants always end up with a tight lower eyelid and satisfied overall?

 

[Artemis]

Thanks a lot. I do want to fix my under eyelids as theyre too droopy and i have pretty bad scleral show. Would you suggest tear trough implant + saddle for that then?

No, i would suggest fillers, if the price is acceptable. You want 1 round of fillers anyways, because you do not know how much you need, and you don't want to install an implant blindly. It is a waste of money,since a serious risk to need a revision.

I dont really know what the saddle does. Also maybe lower lid retraction surgery would be better?

Saddle will raise your lower eyelid, and make your orbit more compact. from your pic, im not even sure you need it, as your orbits already look quite narrow.

You simply need canthoplasty to tighten the eyelid. Retraction surgery maybe im not a specialist, but it usually changes the shape of the lid in addition to raising it. Not sure you need/want this.

 

[Artemis]

But are you sure that patients who get off the shelf implants always end up with a tight lower eyelid and satisfied overall?

Nope.

I heard it from one of the YouTube Taban interviews where he said he can literally shift the implant above the orbital rim this is why he is not using customs.

 

[Deleted member 24889]

DM me

Filler. Do both cheek and inner portion of the rim.

If you like the results, you can do infra + cheek implants but this is expensive. Otherwise, fat transfer is even better but it is very dangerous and unpredictable.

Finally, midface lift fixes this, but it has a risk to look unnatural.

Why is fat transfer very dangerous?

 

[Deleted member 15866]

im not even sure you need it, as your orbits already look quite narrow.

i am not an expert bro but his infras look quite recessed tbh.
dont you see the excess soft tissue and deadly droopy eyelids in the third pic?
And also him saying :

Theres just nothing there no bone no fat nothing.

Nope.

I heard it from one of the YouTube Taban interviews where he said he can literally shift the implant above the orbital rim this is why he is not using customs.

I dont get it, did you mean he doesnt use off the self implants?

 

[Artemis]

Why is fat transfer very dangerous?

Fat does not fully survive. The lower lid skin is very thin. Some dead fat, even if it is little, will form lumps, which are not removable, unless they cut you open, which causes ugly scars.

For this reason, fat transfer is often done in multiple procedures, where they literally correct every tiem what they fucked up the last time until the results are good. But sometimes the result is just the "pufferfish" and you cannot get rid of it like filler.

 

[Artemis]

i am not an expert bro but his infras look quite recessed tbh.
dont you see the excess soft tissue and deadly droopy eyelids in the third pic?

His infras are recessed. But he does not need saddles for them. His issue is that he has those hollows under the eye. The droopy lower eyelid in his case is not because of his infras. Just skin/muscle.

OP does not need saddles, he just needs a simple infraorbital rim implant.

I dont get it, did you mean he doesnt use off the self implants?

No, Taban DOES use off-the-shelf implants. But he uses them like SADDLE implants. Doing the same thing as rim implants with the saddle do: narrowing the orbit vertically and raising the lower eyelid

 

[Artemis]

i am not an expert bro but his infras look quite recessed tbh.
dont you see the excess soft tissue and deadly droopy eyelids in the third pic?
And also him saying :



I dont get it, did you mean he doesnt use off the self implants?

I think we re just need to define what we re talkingabout.

THere are 2 implants: custom and off-the-shelf.

When you want "saddles", which are a specific TYPE of infraorbital implant, where the upper margin of the implant goes above the bone, you HAVE to order CUSTOMS. It literally means "Saddle implants" = "Custom Infraorbital Rim Implants".

While Taban takes off-the-shelf infra implant, which should sit fully on the bone (as in the pic, its upper margin is not above the bone), but SHIFTS IT UP, which makes the upper margin move above the bone. Thus, he effectively makes a "saddle implant" out of it.

 

[ripcordgod1]

I know I have droopy eyelids and negative canthal tilt. I will fix those if i get enough money.

What I could fix right now and bothers me the most is my under eye hollows. Theres just nothing there no bone no fat nothing.
I am considering tear trough fillers, but I read somewhere that maybe cheek fillers would be better.
What do you guys think?

Also what is the cause? I thought my maxilla was recessed, but I have had lower jaw surgery some years ago and the doctor said my maxilla was fine. Is it just recessed orbitals or no cheekbone prominence?

the pictures:

my upper maxilla recession is even worse than this lol its fucking terrible
but the rest of my maxilla is beautiful its just the fucking infra that's fucking me god awful genetics

 

[Deleted member 15866]

The droopy lower eyelid in his case is not because of his infras. Just skin/muscle.

but he has recessed inras?

OP does not need saddles, he just needs a simple infraorbital rim implant.

you say that because they both do the same shit or op's case doesnt require saddles?

While Taban takes off-the-shelf infra implant, which should sit fully on the bone (as in the pic, its upper margin is not above the bone), but SHIFTS IT UP, which makes the upper margin move above the bone. Thus, he effectively makes a "saddle implant" out of it.

Okay i got the sitting thing but didnt understand how it shifts up if no superior implant advancement into orbital but just anterior?

 

[Artemis]

but he has recessed inras?

Yep. Recessed infras: infras are not forward-grown enough. Like jaw recession: in forward-backward direction. Not up-down.

you say that because they both do the same shit or op's case doesnt require saddles?

OP's case doesn't require saddles.

Okay i got the sitting thing but didnt understand how it shifts up if no superior implant advancement into orbital but just anterior?

Implant's thickness is what gives the "anterior advancement" and fixes the recession. Its height is not much, so that it sits on the bone. But you can just take this piece of plastic, and move it up, so that the upper end "hangs in the air" above the orbital rim. This is what saddles is.

This dude had off-the-shelf infras, here how it looks:

Right now, infra implant sits on his bone. There is no part of the implant, that is in the socket. Now imagine, the infra-implant is shifted "up" on his face. Then, part of the implant will be on the bone, and part of it will be above the bone. The bone edge is depicted with black marker.

 

[Deleted member 15866]

Yep. Recessed infras: infras are not forward-grown enough. Like jaw recession: in forward-backward direction. Not up-down.

how do you know if a person's problem is up and down or forward?
some people's infras look "vertically challenged"...

OP's case doesn't require saddles.

the question above will give the answer for who requires saddles i guess...

Implant's thickness is what gives the "anterior advancement" and fixes the recession. Its height is not much, so that it sits on the bone. But you can just take this piece of plastic, and move it up, so that the upper end "hangs in the air" above the orbital rim. This is what saddles is.

This dude had off-the-shelf infras, here how it looks:

Right now, infra implant sits on his bone. There is no part of the implant, that is in the socket. Now imagine, the infra-implant is shifted "up" on his face. Then, part of the implant will be on the bone, and part of it will be above the bone.

yeah i got the difference between custom and off the shelf.
off the shelf just streches the soft tissue with forward advancement and it does the job, right?

 

[Artemis]

how do you know if a person's problem is up and down or forward?
some people's infras look "vertically challenged"...

Negative orbital vector, or hollow under eye, is ALWAYS a "forward"-problem.

Drooping eyelid can be indeed a too round orbit. But from the image of OP, his eye socket does not look too wide vertically. I assessed it from the side pic, having figured where the bone should go. And then, well, comparing to round eyes with wide orbits:

OP's eyes do not look like this IMO, but i might be wrong ofc. This is not some algorithm i have. Only x-ray can show 100%.

yeah i got the difference between custom and off the shelf.
off the shelf just streches the soft tissue with forward advancement and it does the job, right?

Yep

 

[Deleted member 15866]

Negative orbital vector, or hollow under eye, is ALWAYS a "forward"-problem.

ah yeah i am dumb lol should have know that, completely forgot the orbital vector concept for a second.

Drooping eyelid can be indeed a too round orbit. But from the image of OP, his eye socket does not look too wide vertically.

Why does wideness effects the eyelid tightness?

And then, well, comparing to round eyes with wide orbits:

cant see the difference tbh can you explain

 

[Dystopian]

Negative orbital vector, or hollow under eye, is ALWAYS a "forward"-problem.

Drooping eyelid can be indeed a too round orbit. But from the image of OP, his eye socket does not look too wide vertically. I assessed it from the side pic, having figured where the bone should go. And then, well, comparing to round eyes with wide orbits:

OP's eyes do not look like this IMO, but i might be wrong ofc. This is not some algorithm i have. Only x-ray can show 100%.

Yep

Can I pm you?

 

[Artemis]

Can I pm you?

yep. but i answer later im going to sleep now.