What's the Difference Between Pearl Fat Grafting and Fat Grafting?

asked 3 years ago by Babyjoe
Latest answer by Larry S. Nichter, MD, MS
Question viewed 5,320 times

I had Pearl Fat grafting in my lower eyes because I had a Blepharplasty done 2 yrs ago and the doctor took too much fat out. Now he made me hollow in both eyes. So I found a Doctor who does the Pearl Fat Grafting.

I thought the Pearl Fat would be a better choice than the Fat graft. Fat was taken from my lower stomach area and was placed into my lower eyelids from the inside the eyes. Now my eyes look puffy. It's 3 month now and I hope to lose some more puffiness.

I don't like how I look now. Also, I have post hyperpigmentation too. The doctor said I had it before surgery but it was very faded. If you look at the top photo you can see it very faded. So now it got darker after surgery. The doctor said it will go away in a few months. This picture is day of surgery (top) and six weeks later (bottom). I'm 3 months now and I still look the same. I'm not happy. I know the doctor is going to tell me I have to wait longer.

8 answers to What's the Difference Between Pearl Fat Grafting and Fat Grafting?

Pearl fat grafting uses multiple small pieces of fat, composite fat grafting uses one larger piece

Babyjoe, Pearl fat grafting uses multiple (usually 3) small pieces of fat to plump the hollow eye caused by previous blepharoplasty. Composite fat grafting uses a custom formed whole piece of fat to fit into the hollow deformity. Both work well, and some favor the pearl method because they believe the "take" or survival of the graft will be better. I use the whole "composite" graft technique because I like the uniformity of the result, and I "overgraft" to... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

Fat grafting vs Pearl fat grafting

Fat grafting is the procedure. Pearl fat grafting in a technique. Fat grafting can be accomplished using injections (closed technique), or surgical transfer (open technique) of pieces of fat with or without skin (dermis). These pieces can vary small to large. The pearl grafting technique uses an open technique with transfer of pearl sized pieces of fat. IT is generally practiced by oculoplastic surgeons. It maybe that more of the fat survived than you would like. I would address this with... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

I prefer Structural Fat Grafting

Structural fat grafting is a procedure in which small amounts (less than 0.1 cc at a time) of fat are carefully microinjected in a series of discrete layers to gradually 'build' new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist. If this process of blood vessel ingrowth (neovascularization) does not occur, then the injected tissue cannot truly be considered a 'graft' and is instead just... more

Michael Law, MD
Raleigh-Durham Plastic Surgeon

michaellawmd.com

There are several problems with Pearl Fat Grafting

Babyjoe, Three months is early on in the healing process and the "puffiness" will probably get better. I am not a fan of Pearl Fat Grafting. Pearl Fat Grafting has been advocated by certain specialists. The technique involves inserting small "pearls" of fat as grafts into pockets created under the eyes. I think there are several problems with this approach: 1. The fat pearls are usually too big to have consistent graft survival, meaning there will be variability in... more

Daniel Reichner, MD
Newport Beach Plastic Surgeon

Wait longer, revision or open procedure might be needed

They are both the same. Injection of microfat around the eye, is a very technical procedure. The key is always to place the fat deep enough to acheive the volume augmentation with no surface irregularities. You will have to wait a little longer, maybe close to 6 months. If you still have the same problem, a revision or an open procedure might be needed. Good luck!

Hisham Seify, MD, PhD
Los Angeles Plastic Surgeon

Fat Transfer

As other physicians have noted, I would agree that microfat transfer is a bit more reliable than Pearl fat grafting, though every physician has their preference and there is no scientific data to promote one over another. I would also agree that 3 months is early on in the healing process and would likely wait about 6 months before undertaking any other corrective procedures.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

Fat Grafting on the tear trough

The photos look better, but I see your concerns. I think that if he filled you a little more in the tear trough you would not be as tired looking. The hyperpigmentation should resoolve with time- sometimes it takes 6 months to see resolution. Look for doctors who perform the Viafill procedure.

Robert M. Freund, MD
New York Plastic Surgeon

Pearl Fat Grafts vs Lipoinjection (micro fat grafts)

Pearl fat grafts are just what it sounds like - placing pieces of pearl size fat using an open approach. This is to be contrasted with lipoinjection, or structural fat grafting, where small amounts of fat are placed in a layered fashion to encourage better survival. In my experience there is more control and predictability with lipoinjection. Probably more important than the technique and the most important factor of all is the skill and experience of the surgeon. Always check out... more