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Orbital Fat Loss - What Can Be Done? I'm 49, my Eyes Look Much Older. (photo)

I really didn't know what 'Topic' to put this under. I don't want surgery - thinking more along the lines of fillers for the upper lids/brow-bone and lower lids. I've read it can achieve a fuller lid and can be reversed if, I don't like it. I realize it's a temporary fix, but it will buy me some time before committing to a fat transfer procedure. Seeing my pictures, do you think it's possible to obtain a more refreshed, less sad look, with this type of treatment? Thank you in advance.

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age 45-54 fat loss

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16 Doctor Answers | Asked by MsMelody

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Orbital fat loss

The pictures do show a orbital fat loss and very hollow upper lids. From the pictures is also apparent that there some ptosis present. Repairing the ptosis will reduce the aperture of the eyelid opening and help from raising the eyebrows to compensate for the ptosis. Best to seek out an oculoplastic surgeon well versed in ptosis repair and a possible small amount of fat grafting to the upper lids.

Ptosis and hollow upper lids

Melody I would have to see you in person,but I think a good first step in improving your eyes would be doing a conservative upperlid bleph. with levator elevation. Any tissue harvested during the bleph. could possibly be used to make the upper lid concavity less severe. This is not saying that you still might need a filler in the upper lids.If you have fat injected in your upper lids I would suggest you see someone like Sydney Coleman M.D. the professor of fat injections. more

Fat depletion from eyelid areas

You do have hollowing around the eyes from loss of fat tissue support. A fat transfer or filler (done with a very experienced injector who is comfortable working in this area) is a good solution. Before you proceed get an evaluation for the droopy upper eyelids that come from weakening of the upper eyelid "lifting" muscle, (called "ptosis") to see if you need a tightening procedure. That will also help make you look less hollow. Good luck. I think your objectives... more

Eyelid ptosis

Looking at your photos, it seems that your upper eyelids are somewhat droopy [eyelid ptosis]. Furthermore, I think that you are subconsciously elevating your eyebrows to compensate for this. Raising your eyelids [ptosis repair] will definitely help your upper eyelids become less hollow. But you should be aware that your subconscious drive to raise your eyelids may go away and unmask a mild droopy eyebrow. I would recommend consultation with an Oculoplastics surgeon [or a Facial... more

A.J. Amadi, MD

14 reviews

Seattle Oculoplastic Surgeon

seattleface.com

Combination of upper eyelid ptosis and hollowness of lower eyelids

Depending on what is truly bothering you the most, you have several options to rejuvenate your eyes. It appears as if you may have ptosis of the upper eyelids which can be treated with a fairly simple procedure and would help "brighten" your eyes. You also have hollowness under your lower eyelids which can be treated with in office injections with restylane or juvederm or autologous fat transfer. These results can last anywhere from 6 months to several years depending... more

Address eyelid ptosis first

Before considering fillers, please be seen by an oculoplastic surgeon (an ophthalmologist who does eyelid surgery) and have an evaluation for eyelid ptosis. That may be more of what you have than fat loss. Also, when considering fillers, you can always have a saline injection to see if you like the effect. This will go away in a few hours but the amounts and technique can be determined for you if you happen to like it and want to convert to HA's.

Orbital Fat Loss - What Can Be Done? I'm 49, my Eyes Look Much Older.

Great question and posted photos. Options are fillers like HA's or fat grafts. Best to obtain in person opinions.

Orbital Fat Loss - What Can Be Done? I'm 49, my Eyes Look Much Older.

You do appear to have a deep or hollow upper eyelid sulcus. In your case, this results from drooping upper eyelids. Not extra skin, rather excess laxity in the eyelid elevating muscle. This condition is called upper eyelid ptosis and can be repaired. This should improve the appearance of your upper eyelids and should be performed before considering adding any fillers to this area. I hope this information is helpful. Stephen Weber, M.D., F.A.C.S. Lone Tree Facial Plastic Surgeon more

Eyelid Injections Instead of Surgery?

You are correct that we can very often temporize surgical rejuvenation with volumizing injections in the eyelid area. But from the pictures provided, it would seem you could have a medical condition that might require addressing first. Ptosis is a condition in which your eyelids can't be raised fully- when your upper eyelids are in a perpetual state of "half mast". My advice? Get yourself examined before anyone puts any fillers or fat into or around your eyelids. I think you'll... more

Upper Eyelid Ptosis and Volume Loss

I would agree there is some volume loss, but the eyelid ptosis is noticeable and should be corrected. Kenneth Hughes, MD Los Angeles, CA

Treatment of "Sunken Eyes"

You definitely have less fullness than desired in the upper eyelids. However, that is not what appears to be your problem. You seem, from the pictures, to have significant ptosis (droop) of the upper eyelids. Doing either fat grafts or synthetic fillers is contraindicated as they may further weight the lids and make them droop further. The first thing you need to do is see someone who deals with upper eyelid ptosis and have that fixed. If, after that, you still have a lack of... more

Eyelid ptosis?

It looks like from your photos that you have eyelid ptosis.This may make the eyes appear more hollow. Correct that first, and then see if you need fillers, etc.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Upper eyelid ptosis with older appearance

You have upper eyelid ptosis (droopy) which causes your eyebrow to be lifted in order to assist lifting the droopy upper eyelids. That causes the upper eyelid area to be stretched and unveil the hollowness that is present with aging. So, the main treatment would be upper eyelid ptosis surgery. Filler or fat injection can be injected into the brow/upper eyelid area if necessary but that would definitely be secondary. See an oculoplastic surgeon.

Hollow eyes

I agree with trial of filler which is reversible and then if you like the effect .proceeding to fat grafting. However with micrcannulas and experience the results from fat grafting are very reliable and. Softer and more even than fillers in my hand. The key is to not over correct. Fillers or fat can always besupplemented

I'm 49, my Eyes Look Much Older.

It's not possible to tell for sure without an examination, but your photos appear to show significant upper lid ptosis. THis is not something that is corrected by fillers of any type. There are many things that can cause this. Start by seeing your ophthalmoligist for a diagnosis.

Fillers vs. Fat Transfer for Lower Eyelids

Thank you for the question and for posting your pictures. This is a great strategy, and one that I often advocate with my patients. If you are not sure how you will like an augmentation procedure (e.g., fat grafting or placement of a facial implant), you can "try it out" by having some temporary fillers placed. For the tear trough region (hollow area under the lower eyelids), I use Restylane. For the cheek area or lateral brow/temple region, I use either Juvederm or Radiesse. These products... more