Best Way to Add Fat After Aggressive Lower Blepharoplasty?

asked 2 years ago by Babyjoe
Latest answer by William Portuese, MD
Question viewed 1,592 times
Tags: eyelids, sagging

What's the best way to add fat back into eyelid area after lower Blepharoplasty, for a smooth or blended look into the cheek area and lower eyelids? Is it better to put it back where it was taken out, from behind orbital septum? I know the fat that was taken out is different than any other fat in the body. Some doctors use Pearl Fat Grafting or Fat Grafting to give it fullness.

9 answers to Best Way to Add Fat After Aggressive Lower Blepharoplasty?

Eye cheek junction after blepharoplasty

The best way to efface the eye cheek junction and reduce post-blepharoplasty hollowness in most cases is not, in my opinion, to perform fat grafting alone. Rather, a minimally invasive cheeklift is performed, elevating the thicker cheek tissue in addition to placing grafts. If you look closely, there is often a distortion of the lateral eyelid as well that should be treated. Many patients notice that after conventional subciliary (under the eyelid) blepharoplasty, that their eye shape... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

Needs to be put back into normal anatomical position

Fat grafting needs to be put back into normal anatomical position, which is into the orbital septum. If it is put in the subcutaneous space it will be felt and possibly seen.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Fat Grafting Lower Lids

If the lower lids are hollow either by way of surgery or genetics, the treatment of choice is to add that volume-there can also be volume loss with the normal aging process. An easy alternative is to use fillers such as Restylane, Juvederm etc. to add volume. This is done in a chair under local anesthesia and recovery is very short- some mild swelling and possibly some bruising. However, these fillers last for a certain amount of time and will need to be redone two or three times per year.... more

Julio F. Gallo, MD
Miami Facial Plastic Surgeon

Fat transfer is very effective, but usually needs to be repeated

I use fat transfer from the abdomen to the tear troughs and infraorbital rims, blending it into the upper cheek, routinely to correct this issue. It can be done with local anesthesia or IV sedation, depending on patient preference. I think that careful handling, use of fine injection cannulas, and gentle harvesting are keys to a smooth, natural result in this unforgiving area. In my hands, 30-40% of the injected fat lasts a couple of years or longer, and 60-70% is gone within a few months.... more

Anurag Agarwal, MD
Naples Facial Plastic Surgeon

Lower Eyelid Hollow

Dear Babyjoe, The hollow area under your eye can be filled with Restylane or with micofat injections. Restylane is done in the office with freezing/local and brusiing can last for 7 to 10 days. A very nice correction can be attained for 8 months to a year and a half. There are risks with this procedure- most common being prolonged bruising. Micro fat grafting also works well and will be a permanent result. 1/5 patients needs a touch up at 2 months. This is a surgical prcedure done in... more

Trevor M. Born, MD
Toronto Plastic Surgeon

Fat Grafting is effective for eye hollows

In our experience, fat injection into the tear troughs and deformities after lower blepharoplasty are very successful with good "take" of the fat. If the fat grafting technique in the lower lid region is performed with utmost care, it is placed deep to the muscle layer right superficial to the bone. With conservative micro-grafting, you should see a significant improvement with one treatment but we ALWAYS educate our patients that it may require further sessions for best... more

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

Micro fat grafting with good technique.

Hi! This is unfortunately a fairly common problem that we see in New York. I assume you look hollow. 1) For most people with this post blepharoplasty deformity, fat injections are the simplest solution. The problem is that the success of fat injections is totally dependent on how it is done. There are literally a dozen technical details that are crucial. And of course there are no guarantees. But we generally see quite good results. 2) Some patients need repositioning of the... more

George J. Beraka, MD
Manhattan Plastic Surgeon

Consider a Permanent Injectable Filler for your lower eyelids.

Dear Babyjoe, The hollow, operated-look you may have after lower eyelid fat removal is very common. For this reason, I almost never remove lower eyelid fat anymore. I have had wonderful success rejuvenating the lower eyelid with Silikon-1000. This is a permanent filler that is FDA-approved for use in the eye, and can be used in an "off-label" fashion to put volume back in the face. Procedures are performed painlessly with topical anesthetic, and there is no downtime. It would... more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

What you need is a surgeon not a technique.

Dear Babyjoe You may not need a fat graft to restore your lower eyelid. Photos would be helpful to know exactly what your issues are. I would be careful about what solutions are proposed to you and by whom. Most people in your situation have been somewhat traumatized because they were genuinely careful in finding their first surgeon. Learning to trust a second surgeon can be difficult. Generally what happens after aggressive lower blepharoplasty depends on precisely what approach... more