Infraorbital implant for structural dark circles
Structural augmentation surgery of the infraorbital region using facial implants, with anatomical assessment, CT imaging and the option of custom 3D design to adapt the implant to the orbital rim and midface.
WHAT IS AN INFRAORBITAL IMPLANT
An infraorbital implant is a facial prosthesis placed over the bony rim beneath the eye to increase structural support in this area. It may be considered when there is a marked depression, insufficient bony projection or a hollow transition between the lower eyelid and cheek that creates shadowing and accentuates the appearance of dark circles.
Its indication is very different from that of a cream, depigmenting treatment or filler. The implant does not directly treat excess melanin, vascular discolouration, fat pads or skin laxity. Before considering surgery, it is therefore essential to identify which component of the dark circle is genuinely structural.
In selected cases, a custom implant can be designed using CT imaging and digital 3D planning. This allows the implant's extent, thickness and transitions to be tailored to the anatomy of the infraorbital rim and, when required, the adjacent malar region.
The aim is not simply to ‘fill a dark circle’, but to correct a specific deficit in bony support and improve continuity between the lower eyelid and the midface. The indication should be established after an individual medical assessment.
WHEN TO CONSIDER AN INFRAORBITAL IMPLANT
Creams and surface treatments cannot alter a bony deficit. Fillers may be useful for some under-eye hollows, but they do not replace a structural assessment when infraorbital support is significantly reduced. A poor result from filler does not, on its own, mean that an implant is indicated.
When the infraorbital rim has limited projection and creates a persistent depression beneath the lower eyelid.
When the lower eyelid-to-cheek transition is mainly determined by the underlying bone structure rather than only superficial volume loss.
Differences in projection between the two sides that may require a specific, and not necessarily symmetrical, correction.
When reduced support extends into the malar region and the relationship between the infraorbital rim and cheekbone needs to be assessed.
For selected patients seeking structural correction who are prepared to consider surgery rather than resorbable treatments.
Certain congenital, post-traumatic or post-surgical asymmetries may require an implant designed to restore support and bony continuity.
TYPES OF INFRAORBITAL IMPLANT AT FACE CLINIC
There is no single infraorbital implant suitable for every patient. The choice depends on the bony deficit, symmetry, extension into the midface, soft-tissue thickness and the degree of customisation required.
In some cases, a pre-shaped implant may be considered. When the anatomy is more complex or precise control of extension and transitions is required, digital planning allows a side-specific implant to be designed.
Material and design should be selected as part of an individual surgical plan. PEEK and titanium are options used for custom implants, but the choice depends on the anatomy, fixation technique and clinical indication.
Standard implant
A pre-shaped implant that may be considered when the defect and anatomy are reasonably suited to an available design.
See if it is suitableCustom PEEK implant
Digitally designed from CT imaging to tailor thickness, extent and support to the infraorbital rim and the patient's anatomy.
See how it is plannedCustom titanium implant
In selected cases, medical-grade titanium may be used within an individual 3D plan, with fixation determined according to the case.
Discuss my caseInfraorbital-malar design
When reduced support also affects the cheekbone, the design can extend into the malar region to address the midface as a coordinated structural unit.
Request an assessmentWHY NOT ALL DARK CIRCLES ARE TREATED THE SAME WAY
‘Dark circles’ describe an appearance rather than a single cause. Pigmentation, vascular visibility, volume loss, eye bags, tissue laxity or underlying bone structure may predominate. An infraorbital implant is only relevant when there is a structural component that justifies increasing support at the lower orbital rim.
Brown discolouration or melanin predominates; an implant does not correct pigmentation
Thin skin may make vessels and blue or purple tones more visible
Volume loss or a marked transition that may require filler or fat transfer in selected cases
Excess or herniated eyelid fat is assessed according to the principles of eyelid surgery
Reduced infraorbital bony support that may warrant assessment for implant correction
HOW AN INFRAORBITAL IMPLANT IS PLACED
Surgery begins by confirming that the problem is genuinely structural. Clinical examination and imaging allow the infraorbital rim, its relationship with the cheekbone and the soft tissues to be assessed before deciding on implant design, material and surgical approach.
Pigmentation, eye bags, skin quality, soft-tissue volume, symmetry, eyelid position and bony support are assessed to determine whether there is a genuine indication for an implant.
When indicated, CT imaging allows the bony anatomy to be reconstructed in three dimensions, the deficit to be measured and the relationship between the infraorbital and malar regions to be assessed.
For custom implants, thickness, extent, transitions and any differences between the two sides are planned digitally before the implant is manufactured.
The surgical approach, anaesthesia and fixation depend on the individual case. Access may be through the inside of the lower eyelid or via another surgical route when required by the anatomy and treatment plan.
Swelling is expected, and bruising or temporary changes in sensation may occur. Follow-up appointments allow healing, implant position and contour changes to be assessed as swelling subsides.
Dr Francisco Riba explains how digital planning can be used to design custom 3D facial implants based on each patient's anatomy.
BENEFITS OF INFRAORBITAL IMPLANTS
When there is a clear structural indication, an implant can increase bony support beneath the eye and alter the transition between the lower eyelid and cheek. It does not, by itself, correct pigmentation or every component of dark circles.
It can increase bony projection beneath the eye in a controlled way when there is a structural deficit.
It may soften the depression between the lower eyelid and cheek when the hollowing is primarily related to bony support.
Changing the underlying contour may reduce some of the shadowing caused by hollowing, although it does not treat skin pigmentation.
Custom planning allows each side to be designed individually when relevant anatomical differences are present.
Custom implants can be adapted to the bony surface to provide greater control over extent, thickness and the transition into the malar region.
Unlike resorbable fillers, the implant is designed to remain in place long term, although revision, replacement or removal may be required if a complication occurs.
SPECIALISTS IN INFRAORBITAL IMPLANTS
The infraorbital region requires a detailed understanding of the orbital rim, midface, lower eyelid and adjacent structures. At Face Clinic, assessment and planning are carried out within the oral and maxillofacial surgery unit, with custom 3D implant design available for selected cases.
Dr. Francisco Riba García
Medical Director and founder of Face Clinic. Oral and maxillofacial surgeon with more than 25 years of experience and a particular focus on facial surgery, 3D planning and custom facial implants.
ICOMEM 28375865
View medical profileOral and maxillofacial surgery unit
Dr. Matías Cuesta Gil
Oral and maxillofacial surgery · Facial surgery and maxillofacial case planning.
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Dr. Eduardo Monteserín
Oral and maxillofacial surgery · Facial surgery, implantology and complex case planning.
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Dr Gema Arenas de Frutos
Oral and maxillofacial surgery · Facial surgery and personalised maxillofacial treatment.
View profileFREQUENTLY ASKED QUESTIONS ABOUT INFRAORBITAL IMPLANTS
These answers are general guidance. The indication depends on the cause of the dark circles, bony anatomy, lower eyelid condition, soft tissues and each patient's goals.
How do I know whether my dark circles are structural?
Structural dark circles are usually associated with hollowing or reduced anatomical support beneath the eye, creating a marked transition or persistent shadow. They may, however, coexist with pigmentation, a vascular component, eye bags or soft-tissue volume loss. Clinical examination and, when indicated, imaging help distinguish these components.
Does an infraorbital implant replace tear trough filler?
Not necessarily. Hyaluronic acid may be suitable for selected patients with volume loss or a tear trough. An implant is considered when there is a bony structural deficit that justifies surgical correction. These are different treatments, and the choice depends on the diagnosis.
Does it treat dark or pigmented under-eye circles?
It is not a specific treatment for pigmentation. If the dark colour is mainly due to melanin, vascular visibility or skin characteristics, other options should be considered. An implant may alter shadowing caused by structural hollowing, but it does not remove pigment itself.
What materials can an infraorbital implant be made from?
Depending on the design and indication, medical-grade implants may be used, including custom PEEK or titanium options. There is no single material that is universally best for every patient; anatomy, design, fixation and the surgical team's experience must all be considered.
Will the scar be visible?
In some cases, a transconjunctival approach through the inside of the lower eyelid can be used, which does not leave an external skin scar. A different approach may be chosen in other cases. The technique depends on the anatomy and any procedures being combined.
Can the implant be felt?
Palpability depends on the design, implant thickness, position and the tissues covering it. A custom implant is designed to fit the bony surface and control transitions, but it cannot be guaranteed to be completely imperceptible in every patient.
How long does the result last?
Facial implants are designed to provide long-term structural correction and are not resorbed like temporary fillers. However, revision, replacement or removal may be required if a complication develops or there is a later medical indication.
How long does recovery take?
Recovery depends on the extent of surgery and whether it is combined with other procedures. Swelling, bruising, tightness or temporary changes in sensation may occur during the first few days. The result should not be considered final while residual swelling remains.
What are the risks of an infraorbital implant?
As with any surgery, potential risks include infection, bleeding, haematoma, changes in sensation, asymmetry, contour irregularities, implant displacement or exposure, unfavourable scarring, lower-eyelid problems, anaesthetic risks and the possible need for revision surgery. Individual risk should be discussed during the pre-operative assessment.
How much does an infraorbital implant cost at Face Clinic?
The cost depends on the type of implant, degree of customisation, required tests, implant manufacture, surgical team, anaesthesia and the setting in which surgery is performed. Following assessment, you will receive a personalised written quotation.
FACE CLINIC LOCATIONS
You can request an initial assessment at Face Clinic. Our team will advise you which location is appropriate for assessment and, where surgery is indicated, where the procedure and follow-up should take place according to the complexity of your case.
Request an assessment at Face Clinic to review the periocular contour, infraorbital support, soft tissues and available alternatives before deciding whether an implant is genuinely the right option for you.
Request an assessment Individual diagnosis, 3D planning when indicated and a personalised written quotation.
