Plastic Surgery
Dr. Barry Eppley

Explore the worlds of cosmetic
and plastic surgery with Indianapolis
Double Board-Certified Plastic
Surgeon Dr. Barry Eppley

OR Snapshots – ePTFE Orbital Implants


Surgery for vertical orbital dystopia always includes augmentation of the orbital floor. Most of the time the inferior orbital rim is lower as well and needs to be concurrently augmented. Various materials have been used for orbital implants from bone grafts to numerous synthetic implants. In the ‘aesthetic’ orbital dystopia patient (4mms or less of horizontal pupillary  discrepancy) the use of bone grafts is not very appealing.

The ideal method to augment the orbital floor and lower rim is to make custom implants from a 3D CT scan of the orbits. With this technology the exact amount and location of orbital floor and rim augmentation can be determined and made before surgery. This obviates any need for intraoperative fabrication of the implants.

Beyond the use of preoperatively fabricated implants, various materials offer intraoperative workability. One of my favorite implant materials for the orbit is that of ePTFE. Originally known as Goretex, it comes in sheets of various thicknesses that are easily cut and molded to any surface. Composed of a fluorine-based material that is both very smooth and non-reactive, its flexibility and adaptability make it ideal for the complex contours of the orbit.

ePTFE sheets of 2mm thickness can be layered and adapted to the orbital floor and inferior orbital rim as needed. It is a good idea to secure the material to the orbital rim with several micro screws to make sure it lays flat and is as non-palpable as possible through the thin tissues of the lower eyelid.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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