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 compensate for the dissolution of the graft during the time required for the graft to gain new blood supply. Final size and shape of the graft occurs between 4-6 months.
Do not confuse pearl grafting and composite fat grafting with fat injection techniques. Most doctors today are injecting fat through a syringe and calling it fat grafting. It should be called fat injection.
The take of fat that is injected is, in my experience less reliable than with fat grafting and pearl grafting. I believe the injection process damages the fat.
The fullness you note means that the grafts have taken, but I can assure you that they will decrease in size for 3-4 months, possibly longer.
I have my patients massage the swelling of the grafts which I believe helps the grafts settle in-but check with your doctor to make sure he approves of massage.
The hyperpigmentation can be easily removed with IPL treatments-I use the LuxGreen IPL made by Palomar.
