title: Injectable calcium hydroxylapatite for orbital volume augmentation.
abstract: OBJECTIVE
  To describe a new method of augmenting orbital volume for anophthalmic enophthalmos correction.
  
  
  METHODS
  A retrospective medical record review was conducted of 4 consecutive patients who had injectable calcium hydroxylapatite (Radiesse) placed in the extraconal space to augment orbital volume.
  
  
  RESULTS
  Four patients were treated with 1 to 2 vials (1.3 mL per vial) of injectable calcium hydroxylapatite. The mean amount of preoperative enophthalmos measured by Hertel exophthalmometry was 4 mm (range, 2-7 mm). The mean follow-up was 57 weeks (range, 45-71 weeks). A reduction of enophthalmos, ranging from 2 to 5 mm (mean, 2.75 mm), was observed when comparing preoperative with postoperative measurements of the anophthalmic orbit with prosthesis in place. All patients demonstrated clinical and aesthetic improvement that was observed to continue at almost 1 year or more postoperatively. In one patient, injection was complicated by a peribulbar hemorrhage related to local anesthesia administration, which resolved without incident.
  
  
  CONCLUSIONS
  Injectable calcium hydroxylapatite provides a new, safe, simple, cost-effective technique to treat volume deficiency in the anophthalmic orbit. Augmentation achieved with this semipermanent filler has demonstrated a lasting effect in the orbit of 1 year or more with little volume loss. The filler seems to last longer in areas with less movement, blood supply, and lymphatic drainage. Injection can even be performed in an office setting using local anesthesia. The amount of volume replacement can be titrated, and the procedure is repeatable until adequate volume is obtained.
authors.affiliation: Center for Facial Appearances, 1002 E South Temple, Salt Lake City, UT 84102, USA. info@centerforfacialappearances.com
authors.forename: M Reza
authors.initials: MR
authors.lastname: Vagefi
authors.forename: Tristan F W
authors.initials: TF
authors.lastname: McMullan
authors.forename: John R
authors.initials: JR
authors.lastname: Burroughs
authors.forename: George L
authors.initials: GL
authors.lastname: White
authors.forename: John D
authors.initials: JD
authors.lastname: McCann
authors.forename: Richard L
authors.initials: RL
authors.lastname: Anderson
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000627:therapeutic use*; D017886:Durapatite / Q000008:administration & dosage / Q000627:therapeutic use*; D015841:Enophthalmos / Q000628:therapy*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D001672:Biocompatible Materials; D017886:Durapatite