Infraorbital implants for under-eye support
Patient-specific infraorbital implants planned with advanced 3D technology to improve lower orbital support, the transition between the lower eyelid and cheek, and selected structural under-eye concerns.
The objective is not simply to add volume beneath the eyes. Treatment is planned from the facial skeleton to provide precise support where the infraorbital rim is recessed, asymmetric or insufficiently projected.
What are infraorbital implants?
Infraorbital implants are facial implants positioned over the lower orbital rim: the bony border beneath the eye that contributes to the support and contour of the lower eyelid and upper cheek.
They may be considered when this area is structurally recessed, asymmetric or insufficiently projected. Depending on the anatomy, the design may remain focused on the infraorbital rim or extend laterally towards the cheekbone as a combined infraorbital-malar implant.
The aim is to improve anatomical support and create a smoother, more balanced transition between the lower eyelid, orbital rim and cheek without producing an overfilled appearance.
Infraorbital implants are not a general treatment for every type of dark circle or under-eye hollow. The indication depends on whether the concern has a genuine skeletal component and whether implant surgery is appropriate for the lower eyelid and orbital anatomy.
What can infraorbital implants help improve?
Treatment may be considered when the main concern is related to deficient or asymmetric bone support beneath the eyes. A specialist assessment is required to distinguish skeletal deficiency from soft-tissue, eyelid, skin or pigmentation concerns.
The lower orbital rim sits relatively far back, providing limited structural projection beneath the eye and an abrupt lower eyelid-to-cheek transition.
A visible depression beneath the eye has an important bony component rather than being caused only by skin quality, pigmentation, fat position or ageing.
The eye projects forward in relation to the supporting bone beneath it, sometimes described as a negative orbital vector, and the lower eyelid requires careful structural assessment.
The infraorbital contour differs between both sides because of developmental anatomy, previous trauma, facial surgery or another structural cause.
The under-eye area must be assessed as a complete anatomical unit
The visible concern beneath the eyes may arise from several different structures. Dr Riba assesses the lower orbital rim, lower eyelid position, cheekbone, maxilla, soft tissues, fat compartments, skin quality and facial symmetry before recommending treatment.
In some patients, an infraorbital implant may provide the missing support. In others, a different or combined approach may be more appropriate, such as lower eyelid surgery, fat repositioning, facial fat grafting, fillers, midface surgery or treatment directed at the skin.
3D planning for custom infraorbital implants
The infraorbital area is anatomically precise and closely related to the eye, infraorbital nerve, cheekbone and maxilla. In selected cases, CT-based 3D planning allows the implant to be designed according to the patient’s own skeletal anatomy.
The design can be adapted to the required projection, the difference between both sides and whether support should remain beneath the eye or continue into the cheekbone region.
What infraorbital implants can — and cannot — improve
When correctly indicated, an infraorbital implant may improve skeletal support beneath the eye, lower orbital rim projection, selected structural hollows, asymmetry and the transition into the upper cheek.
The result depends on the implant design, lower eyelid anatomy, soft-tissue thickness, healing and whether another procedure is required to address the eyelid or cheek tissues.
The purpose is structural correction, not indiscriminate volume. A natural-looking result requires conservative projection and continuity with the cheekbone and surrounding tissues.
Not every under-eye concern is skeletal
Infraorbital implants do not directly remove skin pigmentation, vascular dark circles, fluid-related swelling, eye bags, malar oedema, festoons or significant skin laxity. They are also not a stand-alone treatment for every case of lower eyelid retraction or functional eyelid malposition.
When these factors are present, Dr Riba may recommend another procedure, a combined plan or no implant surgery. The correct treatment should be selected from the diagnosis rather than from the appearance of a single photograph.
How infraorbital implant treatment is planned
The exact process depends on the anatomy, previous treatments, implant design and whether the procedure is performed alone or combined with lower eyelid or midface surgery.
Recovery after infraorbital implant surgery
Recovery varies according to the implant extension, surgical approach, lower eyelid treatment, patient anatomy and whether other facial procedures are performed at the same time.
Swelling, bruising, tightness, temporary altered sensation and discomfort can occur around the lower eyelid and upper cheek. The contour should not be judged during the early postoperative period.
The lower eyelid-to-cheek transition becomes clearer as swelling reduces and the tissues adapt. Recovery instructions depend on the surgical approach used.
Follow-up is required to assess healing, lower eyelid position, sensitivity, symmetry, implant stability and the progressive result.
Risks and limitations
Possible risks include infection, bleeding, haematoma, asymmetry, contour irregularity, implant displacement, palpable or visible edges, changes in infraorbital nerve sensation, scarring, lower eyelid position changes, dissatisfaction with the result and the possible need for revision or implant removal.
Because treatment is performed close to the orbit, uncommon but potentially serious orbital, eye-movement or visual complications must also be discussed during informed consent according to the planned procedure.
This page provides general medical information and does not replace a consultation. The indication, expected benefit, surgical approach, material, recovery and individual risks must be assessed personally by Dr Riba.
Questions about infraorbital implants
These answers are general. The suitability of an infraorbital implant depends on an individual anatomical and medical assessment.
It is a facial implant placed over the lower bony rim of the orbit to improve structural projection, support or contour beneath the eye. It may be isolated or extend towards the cheekbone.
Not all dark circles. They may improve shadowing associated with a recessed lower orbital rim in selected patients, but they do not directly treat pigmentation, visible blood vessels, fluid retention or skin quality.
No. Infraorbital implants focus on the bone beneath the eye, while cheek implants primarily improve the malar or submalar region. Some custom designs combine both areas when anatomically appropriate.
Neither is universally better. Fillers act within the soft tissues and are temporary. An implant provides structural augmentation at bone level. The correct option depends on the cause of the concern, tissue quality, risk and desired degree of correction.
A custom design may be considered when precise fit, asymmetry correction or combined infraorbital-malar coverage is required. Not every patient needs a custom implant, and some patients are not suitable for implant surgery.
The approach depends on the implant design and whether lower eyelid surgery is combined. The implant is positioned over the planned bone surface and stabilised according to the material, anatomy and surgical strategy.
Medical-grade facial implants are intended as a long-term structural solution. They may nevertheless require review, revision or removal if there is infection, displacement, discomfort, an unsatisfactory result or another clinical reason.
Cost depends on diagnostic imaging, standard or custom design, implant material, surgical setting, anaesthesia, fixation and whether another procedure is combined. A personalised quotation is provided after assessment.
Why choose Dr Francisco Riba for infraorbital implant planning?
Dr Francisco Riba is an oral and maxillofacial surgeon whose work combines custom 3D facial implants, facial skeletal analysis, reconstructive surgery and facial plastic surgery.
In the infraorbital area, this combined perspective is important because the visible result depends on the relationship between the lower orbital rim, cheekbone, lower eyelid, soft tissues and overall facial structure. The objective is a prudent indication and a precise, natural-looking correction.
Structure first, but never structure alone. Dr Riba assesses whether the patient needs bone support, soft-tissue treatment, eyelid surgery, a combined plan or no surgical treatment.
Request your personalised assessment
Send your initial information and Dr Riba’s team will help determine the most appropriate consultation pathway for your under-eye or lower orbital concern.
Patients can request an in-person consultation in Madrid or, when appropriate, a video consultation with Dr Riba before travelling to Spain.
