I think Dr. Wallach thought your surgery was two days previous and if that were the case I completely agree with his assessment. However, if you had fat transfer 6 months ago then you may have issues with the fat not surviving or scar tissue forming where the fat transfer was attempted.
The lower lid and area below the lids is one of the more delicate places on your body and small amount of tissue can make a big difference. When I was in training at Yale University, we had a professor who had spent considerable time analyzing this area and the best way to restore a "hollowed out" look. He correctly concluded that in lower lid blephs when people remove fat, it tends to make people look more gaunt and that the problem is that fat in that area has descended and can be restored by positioning it at a level consistent with its position when you were younger.
The difference between fat transfer and this technique is you're not devascularizing (cutting of the blood supply) to the fat you're moving so it is more reliable and produces a more predictable result (critical in an area where the skin is so thin). In addition - you may have needed a procedure to tighten the skin of your lower lids to begin with and it is possible the fat transfer has emphasized this need. It is difficult to suggest specifically what you should do without a close examination but at 6 months out I think it is likely that you should consider a revision to improve the look of the lower lids.
I hope this helps.
Steven Williams, MD
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