I'm considering to do lower eyelid surgery and the doctor said that he can do conservative fat removal and fat redraping. I fear that since my eye is prominent it may sag the lower eyelid and show more of the white are of my eyes. Would Restylane suit better for my eye anatomy?
Is Fat Redraping Same As Fat Repositioning to Address Eye Hollowness and Bags? (photo)
Doctor Answers (11)
I think you have a tendency for your lower eyelid to retract and so when the doctor does your eyes he amy want to tighten the lower lid with a canthoplasty or canthopexy.Fat addition would help as well.
Fat redraping or filler
Fat redraping may help some areas of depression near the orbital rim but the fat has a hard time reaching the tear trough region. You may need both.
What I see in your posted photos is a visible tear trough especially on the right, a very slight fat bulge on the right and slight muscle bulges just under the eyelashes more so on the right in the no smile. In the smile the fat bulges become more prominent as do the muscle bulges especially on the right. In my experience fat removal through incisions inside or outside the eyelid will create a hollowed out skeleton appearance. Redraping or repositioning the fat over the bone rim under the eye when the before surgery fat bulges go in and out like yours in my experience does not work. Your best bet is therefore a filler inject under the fat bulges. However that will not do anything for the muscle bulges that are very visible in the smile photos.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
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A combination of techniques may your ideal solution.
There are many ways to achieve the desired result here, and different surgeons may offer different approaches based on their comfort level and experience. Both injectible fillers [Resylane and Juviderm] as well as fat transfer can be used to address you problem. With fillers alone, it is a bit more challenging to achieve the ideal result and may need a few syringes for both sides.
One technique that has yielded excellent results, is a combination of conservative fat excision, with fat transfer to the hollows just below the lids [tear trough]
Best of luck
Lower eyelid bags
Fat redraping (or lower lid fat transposition) should not alter the lower eyelid position if done correctly, and it is a good option for you. As you suggested, filler injection is another option. Consult an oculoplastic surgeon.
Eyelid surgery, #blepharoplasty, #tiredeyes, #fatgrafting, #restylane, #beauty
Dear Essence 1981
Thank you for your question! The shaping around the lower eyelids is very important- just as important as the eyelid surgery... adding the volume under the eye eliminates the hollow and provides support for the lower eyelid- preventing the increase in white show. With the surgical approach Fat Grafting gives great results. Non surgically you have Restylane placed on the deep layer to correct the hollow.
With Warm Regards,
Trevor M Born MD
There are a number of good options. As always it depends on the skill and experience of the doctor.
I have had excellent results in many patients like you with conservative transconjunctival laser fat removal for the lower eyelid bags. Redraping is another good approach. Seek consultation with a respected eyelid surgeon and ask to see lots of before and after photos of patients who look just like you.
Web reference: http://www.gatewaylasercenter.com/EyelidSurgery.html
Fat re-positioning in lower eyelid surgery
There are many different methods used to correct the lower eyelids. In many individuals fat repositioning or fat redrapping is appropriate. Also it appears that you have some thickening of the muscle as well. A possible treatment plan may include tightening of the muscle with fat repositioning. Of course an exam would be needed to give you a precise answer. Juvederm or Restylane can fill in the tear trough and may improve the transition zone between the lower eyelid and your medial cheek.
Is Fat Redraping Same As Fat Repositioning to Address Eye Hollowness and Bags?
The short answer is yes; from your photos, I do not see any skin excess, and a very small amount of fat in the lower eyelids. I treat this quite a bit with fillers alone with excellent results. You can choose a dermal filler like Restylane or Juvederm, or you can use your own fat- which can give excellent permanent results. I agree that you need it transferred to the orbital cheek junction. I dont think you need fat removal, as I believe this will make your eyelid look too hollow. Repositioning is an option, but I believe that you need more fat fill than what the repositioning will give. If you choose to have the lower eyelid surgery, then I agree that you should certainly do the transconjunctival approach for the reasons already mentioned. In summary, you have choices, and each Plastic Surgeon will have their preferences on how to treat. Good luck!
Lower eyelid fat redraping vs. removal
I share your concerns. You do have a prominent eye with rounded lower eyelids. While it makes for a very pretty eye it is a set up for lower eyelid retraction in your case for two reasons:
1. If your eye/globe is prominent and projected forward the lower eyelid has a tendency to slip a little lower under the eye after some surgeries.
2. You appear Asian, which can make for what's called a "negative vector." This means that, while you may have prominent cheek bones the bone directly in front and below the eye is set back a little. Basically your bony orbit is more shallow than a white person's. This also sets you up for that slippage and retracted eyelid.
However, this doesn't mean this will happen but it is a risk.
What I see is a young woman with good skin who would benefit from a transconjunctival (behind the eyelid approach) fat removal OR redraping if your surgeon is skillful enough for a redraping via this approach. If your surgeon is suggesting an external cut for fat repositioning in you I'd say that's over-kill.
Filler could help but you need filler in your midface below the eye and immediately below the bag to camouflage that. My practice is 98% Asian and I see this a lot.
Get another opinion
Best of luck
Chase Lay, MD
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.
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