During the previous six years the authors have performed 118 dermis-fat orbital implants. Fifty-one were primary implantations performed at the time of enucleation. Nineteen grafts were implanted after migrated implants were removed, and 19 grafts were used to correct superior sulcus deformities. Nine dermis-fat grafts expanded contracted sockets. It is becoming increasingly clear that these autogenous implants are effective in maintaining orbital volume while preserving the fornicies and conserving the conjunctiva. Although significant atrophy of primary grafts does not occur very frequently, it is more common in cases of secondary implantation, particularly in cases of chemically injured severely contracted sockets (3 of 9 cases). We have noted only one case of significant atrophy following a primary procedure. This occurred two and a half years following an apparently successful primary graft.