Eyelid Surgery: Q&A
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Open Fat Grafting, Fat Injections or Medpore Implants to Undereye. Recommendations?
i have undereye hollows, including tear troughs, without eye bags. may i know the recommended implants for this area, and the downsides of medpore implants to this area? for fat grafting, is it better to have the arcus relesed, together with open fat grafting, or a fat injections in minute amounts per injection?
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7 Doctor Answers |
Asked by
sophie1987
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Different options depending on anatomy.
There are a lot of different anatomic features that we need to evaluate before giving you an opinion on this issue. And to be honest, if you post a photo, you might get five differing opinions. Different surgeons may be confident with different techniques, and they may all get improved outcome using these techniques.
If you have severe bony deficiency, an rim or tear trough or midface implant may be a good option, with possible fat addition. If its relatively mild soft tissue deficiency,...
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Open Fat Grafting, Fat Injections or Medpore Implants to Undereye. Recommendations?
IMHO, I would not use or recommend fat grafting nor tear trough medpore implants. A photo of your face would be required for further evaluation. Suspension type Face Lifts tend to pull the lower eyelids down and not the much heavier cheeks up, IMO. If you truly only have lower lid hollows, a temporary filler would seem the best option IMHO.
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Lower blepharoplsty and midface lift can help the hollow below the eyelid
The hollow below the eyelid responds well to a procedure I perform with midface lift and extended lower blepharoplasty. There is no graft, no implant, no fat transposition. Look at the picture at my page here on RealSelf , the first set under eyelid surgery, 41 year old mother of 4, who had lower blepharoplasty with midface lift and no fat removed.
If you posted a photo of your eyes taken without a flash we could get a better idea of what your particular problem is.
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Treatment of the tear trough
With all of the lesser options available I would shy away from medpor or other facial implants for this problem. The risk benefit ration is much more infavor of injectable filers or fat grafting. Injecting fat even if you inject small droplets has a propensity to form lumps. For fat I prefer open placement of thin sheet grafts as the take rate is high and the incidence of lumps is low. You need to see a surgeon in consultation in order to fully understand the options available to you and...
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Los Angeles Plastic Surgeon
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Under eye filler is the safest option to fill undereye hollows
I agree with all of the concerns noted by Dr. Steinsapir. Given the issues with fat grafting and under eye implants, most surgeons that I work and speak with have shifted away from fat and implants and begun using mainly Restylane to fill this area. Given that you do not have undereye "bags" based on your description you would likely not benefit from lower eyelid surgery. Restylane IS temporary but it's also safe and predictable in the hands of an experienced injector...
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It is impossible to fairly answer your questions without the benefit of even a photograph.
I personally do not think that orbital rim implants should be used just for cosmetic purposes. They simply require far too much surgery for an issue that can often be easily managed with under eye Restylane. I do this surgery to repair damaged eyelids after cosmetic lower eyelid surgery. Fat grafting to the lower eyelid also causes so many issues that I also do not recommend this. I see one or two patient a week who have had lower eyelid fat grafting and need the...
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Under eye implants vs. fat grafting vs. fat injections
The area under the eyes can be tricky, and depends heavily on your age and anatomy. It sound like you don't have a big fat pocket to work with, but would like to soften the tear trough and smooth out the transition from the lower eyelid to the cheek. In patients without fat or tissue volume here, I find filler is usually the best option. Filler is cheaper than fat injection and I feel it gives a more predictable result. There is some risk of injection into a blood...
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