Many people think that facial aging is limited to skin drooping, wrinkles, furroughs, uneven complexion but few realize that this is only 30% of the problem. Fat also disappears from the face and the facial skeleton looses its robust support. Your surgeon should assess all three layers in order to formulate a "flight plan" for you, which you, ultimately have to understand and accept.
Structural fat grafting is used widely to restore the youthful fullness, especially in the cheeks, temples, lateral brow pad and lips. I have used it once, on the dorsum or bridge of the nose, with great results. The periorbital zone is one, which I have avoided because the skin is so thin that any excess volume will be magnified. I usually use a hyaluronic acid filler because I feel it's easier to dose. The good news is that hyualuronic acid lasts over 6months in this site.
Another caveat about fat grafting to the face, it has to be harvested and grafted as gently as possible and placed into a zone, which is adequately vascular. I have had disappointing results with fat grafting in vegetarians and very thin individuals. Something about their metabolism, the fat just melts away. good luck.
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