Dr. Seckel's open composite fat grafting vs. standard fat injections Doctor Answers, Tips
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Dr. Seckel's open composite fat grafting vs. standard fat injections

Hi Guys,   I'm 29 and have had severe under eye hollows/dark circles since childhood. I had some fillers recently from an oculoplastic surgeon and ended up having significant tyndal effect, so i've been put off the fillers. I want a more permanent solution using fat. I've read a lot about normal fat injections and i know there is a significant risk of lumpiness/uneveness, but what really bothers me is that the results only last 3 years or so. I've been reading about Dr. Brook Seckel's procedure (The Arcus Marginalis Release with Fat Repositioning), where he makes an incision inside the inner eyelid using a laser and places an  intact 'chunk' of fat into the hollow depression. I believe the shape of the fat is carved to fit the depression under each eye, which basically prevents lumpiness, as the fat is smooth before being inserted. Most importantly, because the fat is in a solid piece, the survival is incredibly high and totally predictable.   To an average Jo like me, this sounds  like a far superior technique to fat injections. Am i missing something here ? Has anyone had this procedure with Dr. Seckel ? Any other info. on this procedure would be appreciated. Thanks guys.   Link to the procedure : http://drseckel.com/surgical-procedures/result-oriented-removal-of-dark-circles-under-the-eyes/

3 Doctor Answers | Asked by Riz1980
+4

Open Composite Fat Grafting For Dark Circles Is Not Injection or Repositioning

Riz19080, Thank you for your question. Your experience with fillers is very common and I rarely use them. Most often the filler is placed improperly or the function of the eyelid muscle displaces the filler out of the eyelid depression and makes the dark circle worse. Fat Repositioning mentioned below in which the fat is left attached to the vessel is not new, has been done for many years most notably by Dr. Pat Maxwell in Rhode Island. I abandoned Fat Repositioning 10 years ago... more
+1

Fat Transposition and Transconjunctival Blepharoplasty

There are a number of variations of the technique you described. One of the newer variations is by Dr. David Hidalgo who performs the same release of the arcus marginalis but instead of placing a piece of fat into the hollow, he transposes fat from the lower eyelid over the infraorbital rim and secures it in place. Because this fat still has a blood supply, survival and predictability is better than placing a free fat graft into the site. For the right patient, these... more
+1

Transconjunctival blepharoplasty with fat repositioning

This technique has been around for about 10 years and most oculoplastic surgeons will be familiar with it, if not actually experienced in it. It is an excellent technique in the right patient [mild-moderate fat prolapse]. You are correct in that it has a much lower chance of causing uneven lumpiness.

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Comments (1)

Riz1980 6 Oct 2012
Thanks to Dr. Lund and Dr. Amadi for their expert replies, much appreciated. I didn't realise the open composite fat grafting was that popular a procedure, because fat transfer via injections is so much more heavily marketed. Good to know it's a well known procedure by oculoplastic surgeons and not just Dr. Seckel. Thanks again.

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