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Can Eye Bags from Fat Transfer Be Corrected Through Blepharoplasty?

I am 25 years old and I have had fat injections under my eyes about 3 months ago. I had hollowness and dark circles around my eyes, and my plastic surgeon suggested a fat injection. However, I found that the fat has lumped and the dark circles are still visible. It now looks like a have bags under my eyes. I'm really not happy with the results of the procedure and I want to know if it can be corrected by transconjuctival blepharoplasty. However, I don't want all the fat to be taken out because I have found that my eyes aren't as dry as they used to be before the fat transfer.

I am really worried about the bags under my eyes. It makes me look tired and I am really conscious about it. Please give me some advice. Thank you.

Asked 36 months ago by Tuscany in South Africa

Lumpiness after fat injection

Lumpiness after fat injection can occur at a different anatomic place than fat reached by blepharoplasty, so the method of removal will depend on exactly where the fat is. While it is possible a blepharoplasty might correct the problem, it is also possible that the fat is located below the skin, underneath the muscle and not the usual place of below the orbital septum. The skill level for treating this problem is much greater than for a typical transconjunctival blepharoplasty. more

Doctor's Website

Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

You will benefit with a personal consultation with an eye plastic surgeon

Dear Tuscany, Fat transfer can be a fantastic procedure. However, it is very difficult to use in the lower eye lid due to lack of soft tissue coverage. In the cheek or other parts of the face, transfered fat is hidden by the subcutaneous fat. In the lower eyelid, there is essentially no lower eyelid fat. Transfered fat can easily form lumps that present as irregular fullness in the lower eyelid. The situation you are experiencing may or may not benefit from transconjunctival lower... more

Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

Fat injections are excellent for filling eye area, if done well

Dear Tuscany, Well-placed fat injections are an excellent source of filler for the area around the eyes. If done well, it should not be overfilled - but filled to look good at the moment that injections are performed. The one problem with this technique is that some of the fat is dead and will go away in 3-6 months and you may appear less filled than desired. This can be rectified with additional filler. Other fillers do not provide enough volume for the area around the eyes and will make... more

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

Infra Orbital Fat Transfer Correction

Tuscany Regarding the dark circles - filling the depressions under the eyes does not normally correct these circles unless they are created by shadows. Regarding the bags - The most important information needed to correct your problem (under eye bags and lumps) is to determine exactly where the fat was injected. If the fat was injected into the sub-dermal or SOOF spaces a transconjunctival blepharoplasty would not be the best approach. If the fat was injected below the orbital septum,... more

Daniel Reichner, MD

Newport Beach Plastic Surgeon

ASPS

Fat transfer lumps under the eyes can be corrected with transconjunctival blepharoplasty

Tuscany, Yours is a common problem following fat injection to correct dark circles under the eyes. I would wait another 2-3 months for the fat to be less prominent and would recommend massage of the lumps to hopefully improve the appearance. I use a transconjunctival laser incision on the inside of the lower eyelid in the pink part-the conjunctiva. This avoids an external scar and incision which can cause sagging of the eyelid, which could worsen your dry eye. This is a very tricky operation... more

Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Maybe, but depends on how lumpy the eyelids are

This could be very complex. Lumps from fat injections may have to be cut out to get a smooth result. It probably can't be done by transconjunctibal approach, although it might be possible. I would have to see it to determine the best treatment. If you see someone, make sure they are highly qualified, and don't go to the one that injected the fat into your eyelids.

E. Anthony Musarra II, MD

Atlanta Plastic Surgeon

ASAPS

Correcting eye bags from fat transfer to the lower eyelids

There are several ways to correct excess fat in the lower eyelids after fat grafting in this area. Your surgeon may elect to remove these fat bags through a blepharoplasty if they are of significant size. Your surgeon may also elect to perform a small excision and remove this fat directly. If the bags are of minimal size, it may be possible to inject the medication into this fatty area to encourage it to melt away on its own.

B. Pat Pazmino, MD

Miami Plastic Surgeon

ASAPS ASPS

Bags after fat grafting

Your bags may be festoons (swelling of the upper cheeks) which can sometimes occur after fat injections. This is typically temporary and can sometimes respond to dilute steroid injections.

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Sam Naficy, MD

Seattle Facial Plastic Surgeon

Bags under the eyes at the age of 25

The bags under the eyes at age of 25 are probably more related to allergies and/or hereditary pigmentation issues. As there is very little fat present in the lower eyelids at this age, it is very difficult to remove any fat that has been placed in the orbital sockets completely. Bags underneath the eyelids are all caused by fat in three little compartments that can be teased out through a transconjunctival approach if they are causing a noticeable cosmetic bulge.

William Portuese, MD

Seattle Facial Plastic Surgeon

Bags after fat injections

Tough question. It is hard to tell without examining you. But, some of the bags you are complaining about may be residual swelling. If you have lumps from the fat injections, you might want to remove the fat directly through very small incisions on the lower lid. Dark circles are usually either shadows or due to the visualization of the muscle through the thin skin. Some have tried hydroquinone to bleach the skin, but most of the time that doesn't work especially if it is from the muscle.... more

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

The correction may ultimately take time

Tuscany, I would not rush in too quickly to try and remove fat as that can cause more swelling. For the next three months you should massage the lumps as this can often redistribute the fat. If there are specific lumps after 6 months, then they can be reduced with transconjunctival fat removal, usually in an easy procedure. Fat transfer under the eyes can be a very rewarding procedure, so a surgeon with an extensive experience in these injections should be sought out. Good luck. Dr.... more

Andrew Miller, MD

Edison Facial Plastic Surgeon

Yes Surgery and Laser Lipolysis can be helpful

The Contour of the lids can be improved with lower eyelid surgery or laser lipolysis. We are one of the few pracitces to have extensive experience with endo laser surgey of the eyes, face, forehead and neck. These smartlifting techniques help to balance the contour irregularities. Your should wait at least a year to see if the fat will be absorbed. Swelling after the procedure is common.

Richard Gentile, MD

Cleveland Facial Plastic Surgeon

Fat contouring and redraping of existing fat pocket

The fat injected could be contoured and the existing fat redraped to give a youthful appearance. It is a very technical procedure and a good knowldge of the anatomy is necessary.

Hisham Seify, MD, PhD

Los Angeles Plastic Surgeon

ASPS

Yes - eyebags can be corrected

Fat that has been grafted into the lower eyelid area can be removed through a blepharoplasty approach. It may require a standard approach, through an external incision. I would try to find a plastic surgeon who has delt with this problem before.

Robert M. Jensen, MD

Medford Plastic Surgeon

ASAPS ASPS

You can likely be helped, but go to an expert

Tuscany, Operations around the eye can be complicated, especially if you have already had other procedures affecting the tissues (fat grafting / injectables). You can likely be helped, but it is important that you go to someone with experience. It would help if you would post a picture so we could give you more specific advice.

David Shafer, MD

New York Plastic Surgeon

ASPS

Fat transfer bags tricky, but can be corrected

To Tuscany, 1) Don't have any revisional surgery for 6 months. Some of the injected fat may atrophy. Consult with an oculoplastic surgeon. 2) This revisional surgery is technically very demanding. The injected fat needs to be identified and sculpted without creating internal scar tissue. All of the fat does not have to be taken out. I would approach this not transconjunctivally but rather through an incision under the lashes, because accurate visualization is critical.

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Over-corrected fat graft can be treated

Over-corrected fat graft in the eyelid area can be treated with intra-lesional injection of kenalog. This can often times reduce the fullness and correct the deformity. I would certainly try this non-surgical approach before a surgical approach.

Lenore Sikorski, MD

Laguna Niguel Dermatologic Surgeon

Yes

1. I would return to your surgeon for advice. 2. Yes, the fat can be removed, but it may require a traditional blepharoplasty incision rather than a trans conjunctival. 3. There may be an argument for leaving well enough alone, depending on the severity of your concerns.