Dear Doctor Seckel, I will be getting GA for malar implants in a few weeks, but am a bit concerned about placement. My Plastic Surgeon typically places them through the eyes, the blepharoplasty incision and I did a lot of research, consulted with docs who do lower blepharoplasty and who say they no longer do transcutaneous incisions because they are too risky. So I asked my Plastic Surgeon to do it intraorally. He says he can, but as long as I understand “his concerns about positioning and am willing to accept that”…He has done quite a few maxillary fractures surgeries, so I feel he can do it easily without directly looking at the orbital rim. But I need your opinion on what could go wrong, in terms of positioning? Am I being unwise to push my Plastic Surgeon out of his comfort zone?Thank you so very much,It is amazing you take the time to answer people’s concerns, it is an amazing site and I am sure I speak for everyone else when I say I am most grateful to your kindness and recommendations. Sincerely,Fiona M., CO
Fiona,
I completely agree with your decision to avoid an eyelid or external blepharoplasty incision when having cheek implants, malar im[plants or other facial implants such as the tear trough implant.
The risk of ectropion is too great and in addition when placed through an eyelid incision the implant too often ends up displaced laterally.
I assume your plastic surgeon would not do the procedure inraorally unless he is comfortable. Ask him directly.
I use the transconjunctival blepharoplasty approach -that is an incision on the inside of the eyelid which avoids ectropion, when I do fat grafting or repositioning or place my tear trough implants to correct dark circles under the eyes.
If your surgeon needs access to the orbital rim to position the implant
after he has placed them intraorally, ask him if he could do it transconjunctivally.
For more information on blepharoplasty and plastic surgery read Save Your Face or contact me.
Good Luck.
Boston, Massachusetts