Arcus Marginalis Release, Fat Grafting Permanent Under Eye Solution?

The arcus marginalis release and subsequent fat repositioning is a method of distributing fat along the orbital rim in order to soften the visibility of the bony outline. The ultimate result or goal of this approach is to shorten the lid-cheek junction and blend the lower eyelid with the upper cheek. The same result can be achieved by taking fat from another part of your body and injecting it along the orbital rim. This is a fat transfer. In my practice, we do lots of fat transfer... more

Hi! With arcus marginalis release, we are able to redrape the fat in your eyelids to correct the hollowness. With fat grafting, we correct the hollows with fat from another part of your body. So they are different concepts, and they are not done together. Both procedures work well, but they are both technically difficult, and the results are quite variable. In NYC, we use arcus marginalis release or fat grafting when doing lower blepharoplasty, depending on the anatomy of the patient... more

I hate to be the bearer of bad news but fat grafting may not help. The dark circles are caused, mainly, by the visibility of blood vessels through thin skin. However, cheek descent in conjunction with lower lid fat pseudoherniation can lead to light reflective changes that worsen the appearance. I prefer arcus release with fat redraping. This reduces the pseudoheriation and corrects the rim/tear trough deformity. I really don't know about fat grafting the lower lid. You may also need... more