Uneveness and Thin Tear Trough Area Skin 10 Months After Blepharoplasty with Fat Grafting, What Should I do Now? (photo)

asked 5 months ago by info200
Latest answer by Julio Garcia, MD
Question viewed 197 times
Tags: tear trough, 10 months post-op, options, thin skin

After a Blephoplasty and fat grafting 10 months ago, i have been left with uneveness on the lower lid/cheek junction on the RHS. I also have thin skin on the lower eyelids which is always dark especially in the corner going down to the tear trough area. Partly from skin thinness and partly pigmentation. I look old and tired from the darkness and a little strange from the uneveness on the cheek area. The doctor did a second fat graft 4 months ago and the uneveness has now increased. Please help.

9 answers to Uneveness and Thin Tear Trough Area Skin 10 Months After Blepharoplasty with Fat Grafting, What Should I do Now? (photo)

Uneveness and Thin Tear Trough Area Skin 10 Months After Blepharoplasty with Fat Grafting, What Should I do Now?

I think at this time, using hyaluronic acid filler like Restylane to fill the area in is a good idea. That should lift the skin up so the light reflects better on it making it look less dark and will hide some of the depressions.

Julio Garcia, MD
Las Vegas Plastic Surgeon

lvcosmeticsurgery.com

Many different techniques

You have no doubt hear the phrase: "there are many ways to skin a cat". Although I'm unsure of the origin of this phrase, it no doubt applies to this situation. Hyaluronic acid fillers [restylane/juviderm], fat grafting [injection], and fat repositioning [blepharoplasty with adjustment of the eyelid fat] have all been used to address your problem with varying degrees of success, depending on surgeon technique and patient anatomy and healing. Fat grafting was a viable... more

A.J. Amadi, MD
Seattle Oculoplastic Surgeon

Unevenness of Lower Lid after Fat Transfer and Blepharoplasty

You appear to have a failed fat graft with age related deflation of the areas around the eyes. The darkness is related to the thinness of the skin allowing the reflection of the underlying muscle to be seen. Your appearance my be improved with either micro fat grafting or placement of Restylane.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Uneveness and Thin Tear Trough Area Skin 10 Months After Blepharoplasty with Fat Grafting, What Should I do Now? (photo)

The one photos helps a bit but in person examination is always better. I recommend trying small dose short acting Restylane on only the right lower lid to see if there is any improvement.

Darryl J. Blinski, MD
Miami Plastic Surgeon

My lower eyelids are hollow and look tired.

Fat grafting is less predictable than fat repositioning, and even less predictable than off the shelf fillers such as hyaluronic acid or calcium hydroxyapatite. If the appearance bothers you, have it revised, preferable NOT with another session of fat grafting.

Steve Laverson, MD
San Diego Plastic Surgeon

feelbeautiful.com

Grafted fat is less than ideal for such a thin eyelid.

Given how thin your lower eyelids are, at least from the photos, I think the result could be acceptable for some. Generally with skin this thin, the best option is filling the lower eyelid with a product like Restylane. Restylane can be adjusted after the fact, if needed, with a simple injection of hyaluronidase.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Fat grafting after blepharoplasty

Fat grafting should be effective to fill the tear trough and reduce the line and hollow in the lower lid. If the grafts are placed well it should be possible to even out your lower lids without surgery. Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon

Fat grafting tear trough and irregularities.

I have been doing fat grafting for 35 years and I only do it with a blepharoplasty-not by injection. The reason is that fat will make a sausage in the lower lid such as you have. You have 2 choices---1- revision blepharoplasty or 2-slowly adding fillers around the bump. See an experienced surgeon.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Lower eyelid asymmetry after blepharoplasty and fat graft

Hi, It's a little tough to see in the photo but I do detect the asymmetry. Was there a fat bag removed that you're aware of? Was the fat grafted into the tear trough or anterior to the orbital bone rim? Some surgeons have some difficulty with finding the true tear trough without having the area actually open during surgery. I'm sorry I couldn't be of more help. I really need a physical on this one. If this was done via an external... more