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Lower Blepharoplasty vs Fillers for lower lid/cheek bony look

asked 1 year ago by iSore in Midland Park, NJ
Latest answer by George J. Beraka, MD
Question viewed 342 times
Tags: comparison, gaunt, orbital wall

I have been to 2 plastic surgeons and 1 oculoplastic surgeon for opinions. There was no consensus of opinion. I have a narrow face with almost not fat, except for the bulging orbital fat in my lower lids. The area below this fat is very bony and gives the appearance of circles. I'm concerned about the long term effects of removing some of the bulging fat. Also concerned about lid retraction if the lower lid skin is pulled too much. Could restylane be used for the lower lid/cheek bony look?

15 answers to Lower Blepharoplasty vs Fillers for lower lid/cheek bony look

Restylane corrects tear trough.

Hi. Of course there is no way to be sure without examining you, but it sounds like skillfully done Restylane would help you and it is not invasive.

George J. Beraka, MD
Manhattan Plastic Surgeon

Lower blepharoplasty vs fillers

This is difficult to answer without seeing photos or examining you in person. It sounds like you may need repositioning of the fat of your lower eyelid area, not removal of the fat. Also, you may benefit from a fat transfer to restore some lost volume to your orbital area to minimize the appearance of your orbital bone, which makes patients look older. This is a difficult to area to treat, but it must first be diagnosed correctly. Please consult with another board... more

William Bruno, MD
Beverly Hills Plastic Surgeon

Lower Blepharoplasty vs Fillers for lower lid/cheek bony look

Impossible to answer in the form asked. Need photos and the 4 other in person opinions you have seen! My guess is MAYBE RESTYLANE can help. From MIAMI Dr. Darryl j. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon

Blepharoplasty: Pros and Cons

The concerns you mention are legitimate, but rare with an experienced surgeon. The pros of fillers are that they restore volume without surgery, many types are absorbed, and there is minimal downtime. The cons of fillers are that there are complications (as with any procedure), they are absorbed, and in the region you mention – they can be highly visible. If you are a minimalist and want to hold off on surgery – then an injectable may be a nice conservative approach for now.... more

James M. Ridgway, MD
Seattle Facial Plastic Surgeon

Fillers or Lower Lid Blepharoplasty for Boney Mid Face, Lower Eyelid

Hi i, Restylane is very good in filling the hollow under your eyelids. You may use other fillers further away from your thin eyelid skin to give more volume to your mid-face. If you already extremely "boney" it is best to not remove any more fat. Most importantly, choose your injecting physician most carefully. Good luck and be well. Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Many ways to improve your lower eye appearance

Up until recently, there was one way to improve the appearance of the lower eyelids- surgery. With the intoduction and expansion of "off-the-shelf" fillers, there is another tool available. Ultimately, each patient is different, but in most cases, a very nice result can be obtained with either technique.

Lawrence Iteld, MD
Chicago Plastic Surgeon

Orbital Rim Implants May Be An Option for Lower Blepharoplasty Instead of Fat Removal

With flat cheek bones and bulging lower eyelid fat, you should not remove the fat during a lower blepharoplasty. This will only make your lower eyelids look skeletonized or too hollowed out in the long term. One option to consider is to place orbital rim implants which will build out the deficient lower eyelid rim. This will get rid of the bulging lower eyelid fat appearance.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon

Lower eyelid circles

There are two ways to correct the lower lid circles, blepharoplasty and fillers, including fat and off the shelf fillers. Modern blepharoplasty does not remove any of the fat from the lid, but, instead, repositions it. It also supports the lid so that you should not get lid retraction. This is a permanent solution to your problem. Of the fillers, fat is the only really permanent one that I would use. Other fillers are less expensive initially, but have to be repeated. Make sure whomever... more

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Lower Blepharoplasty vs. Fillers

Don't be surprised by the lack of consensus, especially for the issue that concerns you. There are many ways of addressing this. In general, the things that affect the lower eyelids with age are excess fat, excess skin, or both. Excess skin can be removed. If it is done conservatively (which an experienced surgeon will do), you have very little risk of lid retraction. If you have excess fat, you have a few options. First, if it is minimal and you... more

Gary D. Breslow, MD
Paramus Plastic Surgeon

Volume restoration key to lower eyelid rejuvenation

Without seeing you personally, we can only offer general advice, so here's my take: With relatively flat cheeks and not much fat in the face, the problem more often relates to lack of volume rather than bulging eyelid fat. Long-term you will lose fat aound the eyes with aging, so preserving it makes more sense than removing it when you are younger. By adding volume to smooth the transition from the eyelid into the cheek, as is typical in a younger face, the result may look more... more

Richard Baxter, MD
Seattle Plastic Surgeon

Lower Lid Blepharoplasty versus Dermal Fillers

Without pictures or examining you, it is impossible to give you specific advice. However, the approach should not focus on just one issue. It may be best to do a combination of a lower lid blepharoplasty and fat repositioning and/or addition of volume from dermal fillers to achieve the best result. Good luck.

David Shafer, MD
New York Plastic Surgeon

Lower lid blepharoplasty

If you have lower lid bulging fat, camouflaging the lower lid with filler will not cover the herniated fat. The fat can be conservatively removed during a blepharoplasty. The lower lid cheek junction can be filled or released to soften the depression.

Steven Wallach, MD
Manhattan Plastic Surgeon

Lower lid hollows

You have various options as pointed out by your surgeons, including fillers, surgery, or a combination of both. It all depends on your particular eyelid-cheek anatomy and your expectations. Restylane filler is a good safe option if you are worried about eyelid retraction, although if done correctly, surgery has minimal risk as well. Dr Taban

Mehryar (Ray) Taban, MD, FACS
Los Angeles Oculoplastic Surgeon

Today lower eyelid fillers are used more often than surgery

As we age our face looses fat. However, while we loose a lot of cheek fat, very little fat is lost from the lower eyelid. The result is that as the cheek flat melts away the lower eyelid fat becomes more noticeable. For that reason many patients are best treated with filling of the cheek (and the depressed area beneath the bags) with Restylane. If done properly, this give a very natural rejuvenated look. However, filler is not for everybody. Some people... more

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon

Use of Filler to Improve Appearance of Lower Eyelid

You are wise to be concerned about surgery for the lower eyelid. It seems as if you are taking a good approach, seeking out the opinion of different surgeons with different viewpoints. With regard to your question regarding filler, I can't give you a more reasoned opinion without seeing the appearance of your lids but in general, filler can be an excellent option for the aesthetic correction of the lower eyelid. Just as with lower eyelid surgery, be careful. ... more