Fat grafting to lower eyelids

Brent Moelleken, MD answers: Puffy and hyperpigmented under eye area after Pearl Fat Grafting

I had hollowness in my lower eyes from a Blepharoplasty that was done 1 1/2 yr ago. I went to a few doctors in NYC who said putting fat back in the lower eyes is easy, but fat grafting the eyes may look lumpy. So I started looking for doctors online, and found one who does this and he says he's a specialist in this. I had Pearl Fat Grafting done through him 2 months ago, and my eyes went from hollow to puffy. I don't like the way I look, and I don't see the puffiness going down, yet he said it takes time. He told me i also had tear trough deformity, which i noticed before he did anything. I also have hyperpigemention under my eyes, which got darker after the procedure. He said it will fade in time. The photo below shows a day pre-procedure, and 6 weeks post-procedure. This doctor always tells me "give it time", but I'm concerned because I have to go back to work soon, and I need something that can help me as soon as possible. What are my options for getting these fixed?


Brent Moelleken, MD
8 months ago
By Brent Moelleken, MD - Beverly Hills Plastic Surgeon

Fat grafting by any technique is a tricky process for the lower eyelids.  Grafts take a long time to incorporate, metabolize and stabilize.  most surgeons perfoming a great number of lower eyelid revisional cases wait six months before assessing the final results.  However that does not mean you should not be seeing your doctor for microadjustments during that period; this is important as well.

With a negative vector face, prominent eyeballs and flat cheeks, the problem with the lower eyelid is especially difficult.  Some surgeons recommend soft tissue augmentation of the cheek area, in our practice with LiveFill, along with a superficial cheeklift to reduce, but not eliminate the problem.

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