Hi I am 38. Following a traumatic and lengthy detox last year my lower eyelid contours changed, the pretarsal bulge no longer sat neatly under the eyelids, hence the smile lines changed, I now had 'flat' lower eyelids. I don't know if the fat slipped down or if the muscle loosened? I had juvederm filler for the depression of tear troughs but it looked awful, like eye bags. I don't smile anymore. I would now love to have a blepharoplasty with fat repositioning. Can a surgeon perform one if there is still some filler left?? Thanks
Can I Have a Blepharoplasty if There is Still Some Filler Left?
Doctor Answers (10)
Various and diverse opinions
You will most likely get various and diverse opinions in answering your question.
Personally, I would prefer that your filler be completely gone before performing a
blepharoplasty. Any unnatural distortion of the eyelids can potentially effect the
desired contours following surgery. You would only have to wait a matter of months
before all the filler is gone, so why take a chance of creating a problem and potential dissatisfaction?
Blepharoplasty and residual filler in eyelids
You can still undergo a blepharoplasty with fat repositioning even though there is some Juvederm filler still in the orbit. It is important to make sure that the Juvederm is not within the orbital septum creating puffiness since this will just extend the healing time significantly. If there is only a minimal amount of filler left in the eyelids, you can go ahead and proceed with the eyelid surgery.
Best to wait until filler is gone before eyelid surgery
My personal preference is to wait until most of the filler has disappeared, which in the lower eyelids can be more than 6 months after initial injection. This way I can ensure an excellent outcome for the patient.
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Hyaluronic acid fillers can be dissolved prior to blepharoplasty.
Hyaluronic acid can be dissolved with an injectable enzyme, so it is possible to remove the product before undergoing blepharoplasty. That way, it will be clear to see what microsculpting of fat needs to be done.
Blepheroplasty with filler
To be accurate during the surgical procedure you want the filler to be gone. either by time or by dissolving the hyaluronic acid.
It does make the surgery more accurate and precise.
Fillers will not effect lower blepharoplasty
The fillers that are in place should be no reason to not have your lower bleph with fat repositioning. The dissection for the procedure will allow your doc to clear a space along the infraorbital rim to reposition your fat so the filler will not be an issue.
Need personal consultation with expereinced eyelid surgeon to answer this
It is possible to have eyelid surgery in the presence of lower eyelid filler. However, your first job is really to find the right surgeon. That person should have solid training and reputation. However, you need to study their before and after photos as well.
If there are things in their work you do not like, don't assume because the surgeon is charming or that the are reputed to be "the best," your work will be any better that what you see in the before and after pictures. Remember, the surgeon presents these pictures not as representative of their work but because they represent the absolute best of their work. The right eyelid surgey will assess you and determine the best approach for your particular situation.
Best to wait for fillers to dissipate before blepharoplasty
I strongly believe that it is best until all of the filler is gone before proceeding with eyelid surgery. Filler present in the tear trough area can masquerade the orbital rim and allow for misjudgment when removing eyelid fat. It can make the surgery more technically difficult and thus increase the chance of a poor outcome.
If you must have the surgery sooner rather than later, hyaluronidase can be applied to the area to dissolve the filler (if a hyaluronic acid was used). The best option, however, is to be patient and wait it out.
Blepharoplasty can be performed with filler
Blepharoplasty can be performed with the filler in place. However, your plastic surgeon can also remove the filler with Hyaluronidase prior to the procedure if they feel it may interfere with their ability to obtain an excellent result.
In general we like to add the filler after the procedure or during in order to place enough fat in the right position. Occasionally there is not enough fat to transpose and filler is required to enhance the result. Best wishes in your recovery.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.