I am 36, Asian, and have a hollow left upper eyelid as a result of a "failed" Blepharoplasty. I'm looking up fat grafting to correct this. Is it true that the best fat for this procedure is the pubic area fat, since it's more granular, has smaller lobules, and is more viable?
Pubic Area Fat for Fat Grafting?
Doctor Answers (5)
I use composite fat grafting from belly button to correct hollow eyes after blepharoplasty
I use a composite fat graft--that is, a whole piece of intact fat to use for grafting into the eyelids to correct hollow eyes and hollowness of the eyes after a failed
I do not use fat injection or fat transfer because when the fat is aspirated into a syringe, many fat cells die, and failure requiring repeat fat injections is very common.
I also do not like using needles for injection around the eye as the eye muscles and other structures can be injured by blindly passing a needle through the eyelid skin.
The pubic fat can be used but to my knowledge it has no advantage over other fat.
I use the belly button to harvest fat grafts because the scar is very well concealed inside the belly button and is invisible.
Micro fat grafting is an excellent procedure for facial contouring. Secondary work such as the area you mentioned can be tricky and may need more than one attempt no matter the technique or area from which the fat is harvested and how it is placed.
The upper lid/brow area requires a soft touch and care as not to create another problem.
With Warm Regards,
Trevor M Born MD
Fat Transfer requires several key things to happen to avoid resorption of the fat;
1. Harvested under low pressure - no liposuction machines. Hand aspiration with a special device designed to minimize pressure.
2. Concentrate and purify the fat with a gentle centrifuge, not the one typically used today which has been shown to kill many of the cells.
3. Use cannulas to take and inject the fat that are match in size. A large cannula to take the fat, will leave larger granules of fat that won't fit through the smaller injection cannula without loads of pressure -- this kills the cells.
A new tool called the Viafill system is coming out in August, which is designed to address these problems and designed to provide the most live cells for injections.
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Fat is difficult. There is always speculation about what fat works the best for injection. The reality is since there are so many answers by so many different surgeons to this questions there's no good answer. Your surgeon is going to get the fat from the easiest area that provides for the best incision.
Fat is unpredictable and the absorption rate ranges form 30-70+%. So often it has to be done more than once. Good luck.
Pubic fat is an option for fat grafting
Lid hollows after Asian blepharoplasty are an uncommon problem as the patients are younger and the key to the procedure is properly setting the lid fold to shape the lid. Fat reduction is not often indicated. The hollow in the upper lid can also be caused by lower lid blepharoplasty in an Asian patient with fat removal from the lower lid, the hollow appearing as the eye "sets back" from the loss of the fat below.
Fat grafting can be used to correct or soften the problem. The lower lid grafts can be replaced through an injection technique from any suitable donor site. This does require considerable skill and judgment however, and is only a potential solution if indeed fat had been remove from the lower. Fat grafting in the upper lid through injection, structural fat grafts as they are often called can be even more difficult to place safely.
The pubic area you mention is an area which can be used to replace fat in the upper lid. The site was chosen because often the fat is removed as a small strip including a deeper layer of the skin called the dermis. It is the dermis which increases the "take" of the fat graft. The graft is placed through the lid incision along the length of the hollow.
I too have heard the arguments of the fat as more granular but I don't believe them. The donor site works because it is low and easily hidden like a c-section scar. The importance is in the dermis taken with the fat in this location.
Best of luck,
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