Can Open Composite Fat Grafting Be Placed over Orbital Rim?

can the strip of fat be placed over orbital rim implatns or on top to make the eyes less hollow and improves a negative vector?

Doctor Answers (11)

Can Open Composite Fat Grafting Be Placed over Orbital Rim?

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             This method or fat grafting by cannula injection can improve the contours.  Fillers can be used as well.                                                                                                              Kenneth Hughes, MD                                                                                                                                        Los Angeles, CA


Los Angeles Plastic Surgeon
5.0 out of 5 stars 193 reviews

Composite fat grafting over rims?

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If you are referring to using cores of fat for grafting, it would leave contour irregularities that will be quite visible.  If you're talking about micro fat grafting, it can improve the contours as does a lower lid blepharoplsty with transposition of the lower lid fat compartments over the rim.  You should discuss this with your surgeon and since you mentioned negative vector, suggests you already know a lot about this.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 16 reviews

Tear trough abnormality can be addressed at the time of lower lid blepharoplasty.

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The fat commonly removed at the time of the lower lid blepharoplasty can be translocated to fill a tear trough abnormality during the operation.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

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Composite fat grafts to the tear troughs

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Yes composite fat grafts can be placed over the orbital rim to fill tear troughs. I have done it many times and prefer this approach to fat injections because the risk of lumps or blindness is much less. The survival rate of such grafts is much higher here than other parts of the body or face. You do not even need to use a composite. The graft can be a thin strip of fat without any dermis. The trick is to place it right on the bone, suture it in place so it does not move and make sure the strip is not too thick.

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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 in order to know if this assessment is valid.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Fat grafting

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Fat grafting via injection is usually used to address this issue, however, dermis fat grafts, in the form of a strip,  have also been used in this region, usually done to improve lower eyelid retraction at the same time. If you post photos, it would help to see which might be best for you.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 21 reviews

Fat injection of the face is usually better than fat grafting.

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Strips of fat are not used much any more in the face.  This treatment has been largely replaced by fat injection, which allows the operator to be more precise in placement of the fat cells, which may be more likely to survive because they are closer to the recipient blood vessels (the inside of fat strips are farther from their new blood supply and may not survive the transfer).  This treatment is often used in the tear trough area to fill out the infraorbital hollow and reduce a negative vector.  In the right hands, it is safe and can produce excellent results.  I've attached a link to my website in case you want to view some examples.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.5 out of 5 stars 34 reviews

Fat grafting to orbital rim

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Filler or fat can be gently layered over the orbital rim to camouflage the tear trough region and improve the contour. Strips of fat may not be ideal.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Open graft

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The graft can be placed over the orbital rim as you discuss. As an alternative, your own fat can be used as an advancement flap.. You will see a minor change in your vector once the graft or flap heals. Consult a board certified plastic surgeon in your area. All the best

Thomas A. Narsete, MD
Greenwood Village Plastic Surgeon

Dermal-Fat Graft for Under Eye Hollows

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Dermal fat grafting can be done over the infraorbital rim and I have done it numerous times. While it requires an open lower blepharoplasty approach and a donor site harvest, it can very effectively fill in under eye hollows and fat atrophy. The key to doing it successfully is to not oversize the graft and secure along the infraorbital rim. This type of graft does not usually suffer any resorption.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 26 reviews

Dermal fat graft to the inferior orbital rim

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You are describing a dermal fat graft.  In the area of the inferior orbital rim it may be too bulky and visible under the thin skin of your lower eyelids.  I would try a soft tissue filler such as Juvederm and then possibly consider free fat transfer.  Photographs of your area of concern would be useful.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

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.