Anurag Agarwal, MD

I use fat transfer from the abdomen to the tear troughs and infraorbital rims, blending it into the upper cheek, routinely to correct this issue. It can be done with local anesthesia or IV sedation, depending on patient preference. I think that careful handling, use of fine injection cannulas, and gentle harvesting are keys to a smooth, natural result in this unforgiving area.

In my hands, 30-40% of the injected fat lasts a couple of years or longer, and 60-70% is gone within a few months. Hence, I overcorrect and counsel all my patients that they will likely need a follow-up injection in a couple of years. Most people have an adequate supply since so little is required for the lower eyelid area.