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Eyelid Hollowness After Upper / Lower Blepharoplasty

asked 1 year ago by florida4166 in florida
Latest answer by Julio Garcia, MD
Question viewed 1,809 times
Tags: lower eyelids, upper eyelids, hollowness

After having an upper and lower blephoplasty I was left with complete hollowness and new eyelids which look very aging. This was NOT what I originally went in for. The only reason I went in was for my right eye having SLIGHTLY less eyelid showing compared to the left eye which was perfect. Now he made the left eye with more eyelid which I hate and the right eye. What can I do to get my old eyes back or is this not possible?

32 answers to Eyelid Hollowness After Upper / Lower Blepharoplasty

+2

Revisional eyelid surgery

Traditional blepharoplasties involve removing skin and fat. Recently, there has been a move to reposition fat rather than remove it. Also, there is a trend to maintain eye shape by means of canthal or lower eyelid support rather than just removal of fat or a pinch of skin. In the case of a prior upper blepharoplasty where excess hollowness has occurred, we have had some success with fat-fascial grafts placed underneath the orbital septum to restore volume. For hollowness from... more
Brent Moelleken, MD

Beverly Hills Plastic Surgeon

www.drbrent.com

+2

Hollow eyelids and blepharoplasty

Some of the natural consequences of aging are the loss of upper eyelid fat, bulging lower eyelid fat and and the overall loss of facial fat. It is evident that there is virtually no circumstance where eyelid fat should be removed as this causes premature aging and violates our Hippocratic oath to "do no harm". Once the eyelids are hollow, repair and replacement of the fat can be challenging but since fat is deficient the treatment will be fat replacement in the form... more
Paul S. Howard, MD

Birmingham Plastic Surgeon
+2

Eyelid hollowness after blepharoplasty, Eyelid fat repositioning

Unfortunately, a negative of a blepharoplasty is that hollowness may occur. I have changed in most of my cases now to minimally removing the eyelid fat and repositioning what is there to give a smoother,more even transition into the lower cheek and to prevent hollowness from occuring. If it has occured, I have placed fat back from other areas. 
Edward J. Domanskis, MD

Orange County Plastic Surgeon
+1

Eye hollows after an eyelid surgery

The most common cause for the hollowness to appear after eye surgery is from the fat removal. Some deepening of the upper eyelid crease can occur from adherence of the skin to the tarsal plate of the lid, but that is not common. if the hollowness needs to be corrected it likely needs a filler. Some doctors will use the patient's own fat, but I prefer hyaluronic acid fillers as they are more predictable, I feel.
Julio Garcia, MD

Las Vegas Plastic Surgeon

lvcosmeticsurgery.com

+1

Fat Grafting to Correct Hollows of Upper or Lower Eyelids

If you feel that your appearance at the brow-upper lid junction, and your under eye area seems more hollow since having the surgery, this can definitely be improved - and often completely corrected - by means of structural fat grafting. I often perform fat grafting of the brow-upper lid junction for patients referred because of post-blepharoplasty and/or post-browlift hollowness. It is as you might expect a bit more challenging than fat grafting of the unoperated... more
Michael Law, MD

Raleigh-Durham Plastic Surgeon

michaellawmd.com

+1

Eye hollow

In my practice i am very conservative in fat removal during eyelid surgery for this reason..it is hard to determine the exact problem without and exam or pictures...however fillers usually help and may last for some time.....good luck
Michael K. Kim, MD

Fort Myers Plastic Surgeon
+1

This can be improved with filler but is an off label use.

This can be improved with filler but is an off label use.  Look for an oculofacial plastic surgeon who is an injectable specialist for this kind of treatment.
Joseph A. Eviatar, MD

Bronx Oculoplastic Surgeon

www.ChelseaEye.com

+1

Eyes look older after blepharoplasty

Loss of volume in the upper eyelid with aging is normal and requires specific treatment to make it better.  If you are not happy after your blepharoplasty and feel hollowed out, there are a number of options.  It may not be your doctors fault,  but the loss of fat volume in the eye with aging is normal.  After waiting at least 6 months post surgery, you may be a candidate for either hyaluronic acid filler injection or fat injection. I have done both and the results... more
Julius W. Few, MD

Chicago Plastic Surgeon

fewinstitute.com

+1

Correcting eye hollowing after blepharoplasty

Your expectations for your eye surgery were not met,  however you may achieve some improvement by judicious use of "off the shelf" fillers such as Resylane or micro fat grafting.  Both procedures should be done carefully by an experianced plastic surgeon.  These procedures likely will need to be done several time to get maximal benefit.
Jeffrey M. Darrow, MD

Boston Plastic Surgeon
+1

Fat grafting may be the answer

I'm sorry to here that your result was not what you expected. In cases where too much tissue and fat was removed from the eyelids, you may get improvement with the grafting of fat to the upper and lower eyelids. This is a rather touchy procedure and as such, I would recommend seeing a surgeon with extensive experience infiltrating fat into the eyelids. Andrew C. Campbell, M.D. Board Certified Facial Plastic Surgeon  
Andrew Campbell, MD

Milwaukee Facial Plastic Surgeon

www.campbellplastics.com

+1

Correction of Eyelid Hollows after Blepharoplasty

Many times following overaggressive blepharoplasty, patients can be left with a hollowed or sunken appearance.  Overly aggressive fat removal in the upper lid may actually give the upper lid an "aged" look rather than rejuvenation.  To correct this issue I would suggest autologous fat transfer to the upper lid.  When performed by an experienced surgeon, this procedure can help to add volume to the upper lid, and help regain a youthful appearance.  Excess... more
Anthony Corrado, DO

Philadelphia Facial Plastic Surgeon
+1

Eyelid Hollowness

You may have some options - Filler or fat transfer may help improve the hollow appearance.  If there is not enough skin after blepharoplasty, skin grafting may be necessary but it does not sound like this is your issue.  I recommend seeing an oculoplastic, facial plastic, or general plastic surgeon who is comfortable with complex issues in the periocular area.
Keshini Parbhu, MD

Orlando Oculoplastic Surgeon

www.orlandoeyeopener.com

+1

Hollow eyes after blepeharoplasty.

Using a filler like Restalyne or Juviderm will give you the best result. Make sure you see an experienced surgeon who knows how to do this SLOWLY!
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+1

Hollowness of eyelids

Sometimes fillers like restylane or even sometiems fat inejctions can be performed to fill our the upper lids after over-resection but an exam would be necessary to assess this.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Volume Issue

Dear Florida, Volume can be placed in and around the eyelid with micro fat injections or with fillers. Sounds like miscommunication.....and perhaps returning to discuss you issues would be pertinent.    Good luck   Dr. Boxrud 
Cynthia Boxrud, MD

Santa Monica Oculoplastic Surgeon
+1

Best Correction for Hollowed Appearance After Aggressive Blepharoplasty

Hi Florida, Filler, filler, and filler are the answers to your problem.  Restylane can be used, but you need to make sure that you find a qualified expert as the eyelid area is most delicate and unforgiving.  Some would use fat transfer, but in this area I feel that the risks are too high, especially if you are relatively young. Sorry that your blepharoplasty turned out so unsatisfactory.  Good luck and be well. Dr. P
Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon
+1

Eyelid problems after cosmetic surgery

Unfortunately you have some dissappointment with the results of your procedure.  Fortunately you do not have functional issues with lid position problems interfering with vision or over exposure.  Cosmetic dissatisfaction is not rare and uneven lids or "hollow" areas of both upper and lower lids can occur.  Be patient while you recover and discuss your concerns with your surgeon.  It may be possible to improve on your result through injections as... more
David J. Levens, MD

Coral Springs Plastic Surgeon
+1

Too much skin removed for cosmetic blepharoplasty

This is  a very difficult problem to correct and I am not aware of any technique to create more upper or lower eyelid skin other than grafting which is essentially used for reconstructive purposes.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Eyelid Surgery - Volume is the Key

It would be helpful to have some clear photographs of your eyelids to give you specific advice.  That being said, there has been a Paradigm Shift in the Treatment of Upper/Lower Eyelid and Peri-Orbital Soft Tissue aging. With age, there is a progressive loss of volume and fat around the eye, brow, temple and upper cheek.  Think of it this way - you slowly let the air out of a large plastic balloon (with a big sharpie painted-on eyebrow).  As you let the air out,  the... more
Daniel Reichner, MD

Newport Beach Plastic Surgeon
+1

Please seek help in the right places.

Dear Florida Virtually any eyelid surgery can be revised with improved results.  Unfortunately not all cosmetic surgeries delivery everything we hoped for.  Sometimes this is the fault of the surgeon, sometimes though it is because both the patient and the surgeon failed to communicate, and sometimes despite every best effort, things do not go as planned.  However, it is important to understand that eyelid surgeons come with a range of skill sets.  I would encourage... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon
+1

Reversing eyelid surgery

Certain aspects of a blepharoplasty can be partially reversed, but some cannot. It is impossible to tell  what correction can be attempted without knowing what your anatomy was to begin with, what specifically was done in surgery, and what your current goals are. Hollowness due to excess fat removal can be partially or completely reverse with fat grafts. However, if there is not orbital fat available to graft, the surgeon has to use fat from other areas of the body and this fat may not... more
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+1

Hollowness After Upper / Lower Blepharoplasty

Without an examination, it is impossible to determine what will provide you correction. Several things are possible, however. Although the trend in Blepharoplasty is to remove no fat, a large number of surgeons doing eyelid surgery still remove significant fat from both lids. At one time this was the accepted way to do the surgery. If you are simply missing fat from over resection, then fat injection alone may solve your problem. Frequently lower Blepharoplasty only removes some eyelid skin... more
Robert T. Buchanan, MD

Highlands Plastic Surgeon
+1

Eyelid Hollowness

Sometimes with eyelid surgery, surgeons take out too much fat.  This really is from old teaching where most of the fat from the eyelid was removed with surgery.  However, this often leads to a hollow look and actually an older appearance.  The new techniques, remove much less fat to help prevent the hollow look.  At this point, you may need to consider fat grafting to the areas to help improve your appearance.  However, without pictures or seeing you in person it is... more
David Shafer, MD

New York Plastic Surgeon
+1

Eyelid Hollowness After Upper / Lower Blepharoplasty

Your requests for getting the results back of what your eyelids looked like before surgery is not possible.  However, if you feel that there is too much hollowness because of the fat removal, an experienced surgeon in fat transfer can help you with this.  You are right, taking too much fat from the eyes acutally makes the eyes appear more aged, instead of youthful!  Good luck!
Amy T. Bandy, DO

Newport Beach Plastic Surgeon
+1

Eyelid hollows are best avoided

We have learned over years with lid rejuvenation that excessive fat removal from both the upper and lower lid in blepharoplasty are best avoided. No one likes the fullness and bags in the lower lids, though a hollow look can be just as concerning. Current concepts in lid rejuvenation include fat preservation and  repositioning. Hollowed lids can be improved with careful fat grafting into the upper and lower lid. Some surgeons like fillers though we feel the natural fat a better solution... more
Peter E. Johnson, MD

Chicago Plastic Surgeon
+1

Hollowed look after eyelid surgery

Sorry to hear about your outcome with blepharoplasty. It sounds like too much fat was removed. This might look good initially, but with time it gives you a 'reptilian' look. Fortunately, this can be corrected with fillers, either temporary or permanent. I prefer microfat grafting this area. Without photos it is hard to estimate how much you need to get this corrected. You shoud have this done by a plastic or occuloplastic surgeon with experience with this procedure. Good luck. more
George Marosan, MD

Bellevue Plastic Surgeon
+1

Blepharoplasty Contouring can be adjusted with Restylane or Juvederm

Blepharoplasty can alter the eyelid show following surgery.  In general it can take 6 months to a year for the eyelid swelling to settle.  Minor adjustments to a hollowness sometimes seen in thinner people in the upper or lower lids can be diminished with off label use of filler products such as Restylane or Juvederm.  It is always a good idea to discuss your options with your plastic surgeon as they will be able to examine the eyelids and make a better assessment of all the... more
Charles Perry, MD

Sacramento Plastic Surgeon
+1

Save the fat with blepharoplasty

You are right in that loss of fat around the eyes contributes to the appearance of aging. In a younger patient with bags under the eyes, removal of the fat will look OK for a while in many cases but then much worse later, which is why the trend now to preserve the fat and reposition it. It may be possible to have some fat grafted back in or use a graft of tissue to restore some volume.
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Eyelid hollowness following surgery

If you thought the left eye was "perfect" why in the world would you let anyone operate on it? You best option at this point is to use a filler such as Juvederm in the upper lid sulcus which will decrease the eyelid show. 
Peter T. Truong, MD

Fresno Oculoplastic Surgeon

www.facialsurgerydr.com

+1

Eyelid Hollowness After Upper / Lower Blepharoplasty

Regarding: "Eyelid Hollowness After Upper / Lower Blepharoplasty After having an upper and lower blephoplasty I was left with complete hollowness and new eyelids which look very aging. This was NOT what I originally went in for. The only reason I went in was for my right eye having SLIGHTLY less eyelid showing compared to the left eye which was perfect. Now he made the left eye with more eyelid which I hate and the right eye. What can I do to get my old eyes back or is this not... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Reversing a blepharoplasty is not possible

Without a photo it is hard to say but the only way to reverse hollowing from taking out fat in a bleph would be to use fillers or fat grafts.  Sorry for your troubles. 
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Unhappy with eyelids after blepharoplasty

First I would start by reviewing your preop photos to decide how best to proceed.  We would use a temporary filler to see if the result is what you desired.  After a  period of time we could then use a permanenet filler or do a small transfer of your own fat.
Robert Whitfield, MD

Milwaukee Plastic Surgeon

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