Blepharoplasty Left Me with Hollow Eyes (Upper & Lower). L.A. Doctor Recommendations?
- Asked by Timaru in Los Angeles
- 2 years ago
I need a highly skilled doctor to fix hollowness in the Los Angeles area. I am looking into fat grafting. I have tried filers and don't find it does much good. I am extremely scared of getting a lumpy look with surgery. Please advise.
Fat grafting is often unsatisfactory.
Hollowness is caused by natural midface descent and excess lower eyelid fat removal. Fillers for this type of volume deficiency can be a good option for some. However lower eyelid fillers is an art form. If the doc does not use enough volume and lacks artistry, well you get the idea. Fat grafting for this area is usually unsatisfactory. The fat is typically placed in a way that does not respect surgical planes. This means that new scar tissue is formed with these procedures in places that scar tissue does not belong. This can affect how these layers glide over each other. Another issue is lumps that are created when the grafted fat does not take in a uniform way or is not placed in a uniform manner. Remember, the skin is extremely thin in this area. I prefer correcting the midface ptosis in these situations with a vertical midface lift over a hand carved orbital rim implant. These are very complex surgeries that are not right for ever person with this issue. For this reason, the fillers, properly done are now the most common approach for these issues.
Web reference: http://www.lidlift.com
Hollow eyes after blepharoplasty
Hollow eyes after conventional blepharoplasty are quite common.
In our practice, it is usually necessary to place grafts back into the upper eyelid crease and perform a cheeklift while placing grafts to the lower eyelids at the eye-cheek junction.
For grafts, we prefer fully viable fat-fascial grafts to fat injection.
As to which doctor to choose, it helps to see publications and an innovative interest in the area you are seeking, especially when you are having revisional surgery. You may not get a third chance.
Web reference: http://www.drbrent.com/index.php
Dermis fat graft
Depending on the level of hollowness and the position of the eyelid against the globe [whether there is retraction present or not], another option would be a dermis-fat graft which is placed in a deeper layer and usually is devoid of "lumpy bumpy" results. There are many excellent oculoplastics surgeons in the LA area. ASOPRS.org is an excellent resource.
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Eyelid Surgery Photos
Best Oculoplastic Surgeons for Correction of Periorbital Volume Loss
Hi Manhattan Beach,
I would recommend either Jonathan Hoenig, MD (Beverly Hills and Encino), or Robert Goldberg, MD (Westwood), both are excellent and very well respected oculoplastic surgeons who are experienced, skilled, and caring. Good luck and be well.
Hollow eyes after blepharoplasty.
I don't like fat used in the eye hollows as this will often form a "sausage" look under the eye and need to be removed surgically. Juviderm done properly will improve the hollow, but it should be done gradually so as not to make a lump.
Treatment of hollow eyes
Contrary to the up answer indicating that tip that fat transfer is not a good idea, I disagree. My experience it has a high degree of success and minimizing the hollowness beneath the lower eyelids.Tips and Links to find Best Plastic Surgeon Near You
I would seek the advice of a board certified plastic surgeon. See the below links provided on the best way to choose the most qualified plastic surgeon and also how to find one in your geographical area.
Correct Hollow Eyes With Fat Grafting
Many of my brow-upper lid junction structural fat grafting patients have come to my practice for the correction of hollowness created by the over-zealous removal of fat during an upper blepharoplasty surgery. I am continually amazed at how many cosmetic surgeons practice 1970's-era blepharoplasty surgery in the 21st century. I almost never remove upper lid fat during blepharoplasty surgery, and in many cases I actually add fat at the brow-upper lid junction. Fortunately, essentially all cases of post-blepharoplasty hollowness can be improved dramatically by structural fat grafting. It is a more challenging procedure, as scar tissue must be overcome to create space for the grafted fat, and in many cases it takes more than one fat grafting procedure to restore adequate fullness in these patients.
Lower lid hollowness following an overly aggressive lower blepharoplasty can likewise be improved. One must exercise care and caution, as lower lid skin and the underlying soft tissues are usually quite thin, and thus the lower lids are less able to conceal grafted fat. Fat grafting must be preformed conservatively here, with a plan for secondary and occasionally tertiary fat grafting procedures depending on the 'take' of the initial fat grafting surgery.
Many patients referred to me for treatment of these frustrating and difficult post-blepharoplasty problems have reported more than just a cosmetic improvement. Excessive removal of skin and fat during upper and lower blepharoplasty can impair normal lid function and cause or aggravate dry eye syndrome. In some cases the fat grafting procedure will restore suppleness and flexibility to peri-orbital soft tissues, make eyelid closing easier, and improve the truly irritating and aggravating symptoms of dry eye syndrome.
Take a look at many, many before and after photos of fat grafting around the eye area, including plastic surgeons that have performed corrective surgery as part of your selection process when researching surgeons to help you.
Web reference: http://www.michaellawmd.com
L.A. Doctor Recommendations
The ASPS website would be a good starting point to find a qualified surgeon. Some possibilities include Dr. Libby Wilson and Dr. Jennifer Keagle. Consult with 2 - 3 surgeons in the area to find the one that best meets your needs.
Los Angeles doctor
Consider UCLA oculoplastics or looking at the ASOPRS website for an oculoplastic surgeon. There are several means to achieve the desired appearance for your hollowness that might require grafting or lower and mid facial elevation.
A great source to find surgeons is on the ASPS or ASAPS website. You may also consider an occuloplastic surgeon of which I am sure there are some very god ones in your area.
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.