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Options for Reducing Under Eye Puffiness from Pearl Fat Grafting?

I had Pearl Fat Grafting to correct hollowness after lower Blepharoplasty. However, the area became puffy after the fat grafting. It has been 3 months and so far, there has been no improvement in the puffiness. I'd like to know, what are my options if the puffiness doesn't subside anymore?

Asked 36 months ago by Babyjoe

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3 months postop pearl fat grafting

Fortunately, you are 3 months postop and you have another 3 months or so to go before you see a permanent or near permanent result. You may want to talk to your surgeon about steroid injections or massage. If this were the 6-month timepoint (which it is not), the problem becomes a little more complex. In my experience the best method is to perform direct excision of the grafts rather than to perform a transconjuunctival blepharoplasty, liposuction of the fat, etc. Your eye configuration is... more

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Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Fat Grafting

It looks as though the fat grafts have taken well. What I see is a hollow below the fat grafts. Perhaps more injections at the inferior border of the grafts would camouflage the area. I woyuld be ceratin that the fat grafting is done with the viafill system - no overfill is necessary.

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

Consider the use of fillers

It would be best to wait. However, I would advise that you consider the use of fillers to the persistent tear trough and malar rim to achieve "blending" of the eyelid cheek junction. The other option is to undergo a transconjucntiival removal of the lower eyelid fat pads.

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

Pearl grafts can be contoured or removed after 6-12 months

Babyjoe, I agree that you should wait 6 months as the grafts may shrink a great deal more. If after 6-12 months the Pearl Grafts are still causing puffiness, they can be contoured or partially removed. I use a transconjunctival approach using a laser incision on the inside pink portion of the lower eyelid-this does not leave a scar and permits better visualization of the grafts. I would avoid steroid injections. It is impossible to predict the amount of fat and soft tissue dissolving that... more

Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Fat grafting to the lower eyelids

Fat grafting to the lower eyelids is a very effective and powerful procedure. In this area, a small amount of volume goes a very long way. For this reason it is incredibly important to work with a plastic surgeon who is very well versed in fat grafting techniques and blepharoplasty. If you have puffiness after such a procedure, keep in mind that approximate 20% of the fat that was transfer to this area will melt away on its own. You may be well served by being patient and waiting for... more

B. Pat Pazmino, MD

Miami Plastic Surgeon

ASAPS ASPS

Pearl grafting for eyes

I agree with advice to wait about a year. One of the great limitations of PEARL grafting is that it only addresses the orbital fat but not the underlying cheek fat. Looking at your pictures you also need to have the cheek (malar) fat augmented.

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