I am deciding between getting a U/L transconjunctival bleph or that procedure combined with fat transfer to the cheeks and and perhaps under eye if needed. I have bags where fat needs to be removed and transposed. In addition, I have a very gaunt face (flat cheeks) and temples. Will the swelling from adding fat to my cheeks distort my eyes or stitches? Is it best to do the eyes alone, add fat later?
Is it Okay to Combine Blepharoplasty with Cheek/Under Eye Fat Transfer?
Doctor Answers (9)
Blepharoplasty and Composite Fat Grafting are usually done at the same time
Thank you for your question. The answer is yes. I always do Fat Grafting when I do a Lower Blepharoplasty. I also do it through a laser incision on the inside of the lower eyelid called the Transconjunctival Blepharopasty.
Note I am talking about Composite Fat Grafting where a whole piece of Fat is harvested from the pubic area and grafted into the depression or hollow under the eye.
I am not talking about Fat Injection.
It is best to do the Fat Grafting at the time of Blepharoplasty so that the Fat can be positioned properly for best effect.
Eyelids and fat transfer
It is perfectly acceptable to do upper and lower eyelid surgery, including transconjunctival approach to the lower eyelids. You could also do fat transfer or grafting all at the same time. I would graft to the upper and lower cheeks and temples. However, I would not recommend doing fat transfer to the lower eyelids. This is relatively risky all by itself, even worse to do an eyelid procedure then graft on top of it. The swelling would make the final result very unpredictable.
Combining blepharoplasty and facial fat grafting is common
It is quite common to combine blepharoplasty with facial fat grafting. This is the preferable route for most patients as it saves on surgery costs and creates just one recovery period. In my practice I have not found fat transfer swelling to negatively affect the eyelid surgery results (or vice versa).
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Can a Blepharoplasty and fat transfer procedure be combined?...
A blepharoplasty and fat transfer to the cheek and eye area can easily be combined. Using fat grafting under the eyes in addition to upper and lower blepharoplasty gives the hollowed areas under the eye and cheeks additional volume and improves the skin condition. Fat transfer is done by gradualy building up the areas with multiple injections thoughout the year to reach the desired youthful appearence. There will be some swelling from the procedure but it does not interfere with the blepharoplasty sutures. Consult a baord certified facial plastic or plastic surgeon to see if you would be a candiate for this procedure.
Fat transfer and blepharoplasty
This is a very reasonable surgical combination. There is no contraindication for combining lower lid blepharoplasty, open or transconjunctival, with fat grafting. Fat grafting and lower lid blepharoplasty both carry risks with surgery, so meet with a Board certified plastic surgeon to discuss. Lower lid fat grafting may resorb or may harden.
Cheek augmentation with Fat at the same time as Upper and Lower Blepharoplasty
I routinely do this combination of procedures together. This combination is often performed alone or as part of my facelift procedure. Simultaneously having the lower eyelid fat/muscle issues addressed while performing cheek augmentation is ideal, as the infraorbital V shaped deformity is corrected.
Your photographs aren't available for review so I can't advise you as to how I would proceed with your case, but the upper/lower blepharoplasty and fat augmentation is a great combination.
Blepharoplasty and fat transfer work well together.
Without pictures it's hard to advise, but here are a few general points:
1) Transconjunctival UPPER blepharoplasty (unlike lower blepharoplasty) does not work well. It's best to treat the upper lids through the skin.
2) If lower lid fat is re-positioned properly (instead of just being removed), you may not need fat transfer to the lower lids.
3) Fat transfer to the upper cheeks is usually a very good idea.
It is perfect to combine
It is absolutely perfect to combine these procedures. In my opinion they are great to do together. As we age, we gain fat in areas we do not want, such as the lower eyelids, and loose fat in areas we need it such as the cheeks. These procedures redistribute the fat to the areas we need. Hope this helps!
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