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What is Transconjunctival Open Composite Fat Grafting?

First let me thank you for suggestions on revision eyelid surgery. It has taken me 7 years to get here. You mentioned Transconjunctival Open Composite fat grafting. Is it another form of injectable filler? Please explain.

I have done much reading, find injectable filler is only a temporary fix, and most fillers are absorbed. Even your own body fat leaves only a small percentage permanantly behind.

If yours is a fat transfer, much like a skin graft, only fat strip graft placed under skin, it is supposes to be most effective. Finding a surgeon to perform this, not so much. I travel to Cape Cod annually.

Doctor Answers 2

Open composite grafting is not an injection but a piece of fat is surgically transplanted

Injection techniques around the eyes are "blind procedures" and accuracy is difficult to achieve.

Injections around the eyes are traumatic and often leave visible lumps and discoloration of the eyelid skin.

Blindness has been reported following filler injections around the eyes-the filler material enters a blood vessel and disrupts blood supply to the retina.

Fat injection techniques kill a great many of the injected fat cells so that survival of the fat is very difficult to predict. In addition lumps and irregularities are common following fat injections in the eyelid area-the eyelid skin is so thin that any irregularity beneath the skin is very visible.

For these reasons and to achieve the best result when treating hollow eyes after blepharoplasty or treating dark circles under the eyes, I use a fat transplantation technique in which a whole piece of fat of proper size to achieve restoration of volume is surgically transplanted under direct vision into the appropriate position, through a small laser incision on the inside of the eyelid. Placing the incision here avoids disrupting the lower eyelid support by making an external incision and cutting through the muscle. The later technique causes the sad eyed look or ectropion.

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