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Lower Eyelid Blepharoplasty and/or A Fat Transfer The Best For Me?

asked 11 months ago by nexus21
Latest answer by Vivek Bansal, MD
Question viewed 413 times
Tags: lower eyelids, under eyes, male, combination, fat injection

I have been advised that treatment for my dark circles can be approached through lower eyelid blepharoplasty, filler (or fat) for the lower eyelid/cheek interface, or a combination of both these approaches. Which approach would you recommend? If I do not have filler and proceed only with blepharoplasty could I be headed for an overall magnified hollow look? If I only have filler or fat injections will my eyelids look too puffy? thanks for you help!

12 answers to Lower Eyelid Blepharoplasty and/or A Fat Transfer The Best For Me?

Eyelid Surgery

Dark circles can be caused form many factors. Too little fat, lax skin, skin vascularity, hyperpigmentation, and anatomical bone structure, and others. You need to have the problem defined, and start with least invasive to more invasive. I am only moderately fond of filler under the eyes. On some occasion, there can be a puffy appearance. This is not one of the ironclad injection sites. The body response is not always predictable. Proceed with caution. more

Vivek Bansal, MD
Danville Plastic Surgeon

Treatment of Dark Circles Under Eyes

Both injection of filler (including fat) and Lower Blepharoplasty alone when done properly can markedly improve dark circles under the eyes. Which is best depends on the specific problem and the anatomy causing the problem. The only way to know for sure is with a consult and examination of your eyes by a surgeon who specializes in eye rejuvenation. If a Blepharoplasty is done, you need fat moved into the lateral area to disguise the bony orbit there. I would, therefore, not remove... more

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Fat transposition lower eyelid blepharoplasty for correction of dark circles

Lower eyelid blepharoplasty should always be approached with extreme caution since this can be frought with irreversible complications. as we age we loose fat around the eye. if toomuch cat is remove the eye hollows out prematurely . Dark circles (valley) causing the tired appearance can be the result of bulging fat (mountain) In some case, as in your, it is advisable to move the fat (mountain) into the dark circles (valley) . This way volume is preserve and th eyelid smoothed out. I will... more

Kofi Boahene, MD
Baltimore Facial Plastic Surgeon

Dark Circles Blepharoplasty and Filler injections.

In short: combination of both lower trans-conj Blepharoplasty and filler injections. Per the pictures I can see fat herniation of the medial and central fat pads but also a trough (or hollowness) at the junction between your cheek and the lower eyelid. I usually address the hollowness first with Fillers (I prefer Radiesse for that region) and if I cannot camouflage entirely the fat pads then I would do a conservative (to avoid the hollowness) trans conjunctival Blepharoplasty. I would avoid... more

Henri P. Gaboriau, MD
Seattle Facial Plastic Surgeon

www.sammamishfacial.com

Lower eyelid surgery to remove the lower eyelid fat pads

The photos show lower eyelid fat pads in all three fat compartments but more so in the medial and central compartments. Lower Blepharoplasty (eyelid surgery), I prefer transconjunctival with the incision on the inside of the eyelids could do this in about 30 minutes.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Lower Eyelid Blepharoplasty and/or A Fat Transfer The Best For Me?

I always tell my patients to have the surgery that makes the most sense to them, but to go with what the recommendations are with the Dr. that you choose. This is because each Plastic Surgeon will have their preferred technique that works the best for them in their hands in a given situation. If you were my patient, I would definately prefer fat transfer, because you do not have any laxity of the skin to warrant a blepharoplasty, and your bags are minimal. Adding a small... more

Amy T. Bandy, DO
Newport Beach Plastic Surgeon

Preferred Treatment for Under-Eye Hollows

Your condition is a relatively common one and deserves accurate analysis and discussion. Your esthetics after a procedure will vary greatly by the route you choose with your surgeon. The treatment approach should always be guided by your anatomy. It looks to me that you actually have normal lower lids but significant deficiency of your central cheek bone. This leads to the appearance of baggy under eyes. Without examining your side view photos, it is a little difficult to determine... more

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

Fat transfer works great under the eyes

A lower blepharoplasty (through a transconjunctival approach) with fat transposition will fill in the bags and circles under the eyes quite nicely. If there are any pigmentary changes of the skin under the eyes, this can be potentially be treated with a chemical or laser peel. Fillers would also do the job quite nicely; however, in my opinion, they are inferior to fat transposition due to the fact that they are not permanent and need to be re-injected.

P. Daniel Ward, MD
Salt Lake City Facial Plastic Surgeon

Blepharoplasty for bags under eyes with dark circles.

Blepharoplasty for bags under eyes with dark circles and the transfer of fat should resolve all of your issues unless you need something for pigment in the skin. The fat is removed from the mountain and put in the valley of your lid.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Options for dark circles

You do have a variety of options to improve the "dark circles" under your eyes. You have to decide if you want a surgical approach (blepharoplasty) or nonsurgical approach (injectables such as Restylane vs fat). What will give you the best longterm result is a variation of lower blepharoplasty called lower fat transposition where the buldgy lower eyelid fat is transposed to the hollow area underneath it. Dr Taban

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

Blepharoplasty or Fat Transfer

I absolutely agree with Dr. Steinsapir that there is no one correct answer. What works in the the hands of one surgeon may not be successful in the hands of another. I can tell you that my approach for you would most likely include a transconjunctival blepharoplasty to diminish the bulge under the eye, with the understanding that the optimal result might require the addition of fillers such as Restylane afterwards. I also agree that while fat can achieve great results as a... more

Alan Brackup, MD
Philadelphia Oculoplastic Surgeon

Recognize that there is no right answer.

Much depends on your actual surgeon. You could have benefit by a properly done lower eyelid surgery using an transconjunctival approach with arcus marginalis release. I personally think fat is not a great option. It tends to be disappointing over long periods of time. I think for ease of having the treatment and the ability to adjust a service, Restylane and Perlane fillers are much better options. However, there is more than one way to go about this. A... more