Upper Eyelid Hollowness 6 Years After Surgery

I originally planned to only have lower eyelid...

I originally planned to only have lower eyelid surgery because I was always bothered by bagginess that made me look tired. There was some droopiness to the upper lids so the doctor suggested fixing that at the same time. I have fairly closely spaced eyes, and he told me that my age would show in my eyes more than anywhere else on my face, so having my eyes done could help me look younger longer.

The surgery was painless, and I had very minor discomfort afterwords. But immediately after surgery, I noticed that the left upper lid suture was not pulled tightly together. I kept ice (or frozen peas) on it as recommended and slept sitting up for more than two weeks. The next day when I went back to the doctor to have the stitches removed, he said it was fine -- that it would heal OK and that any scar would fade in time.

I had upper and lower blepharoplasty in Jan 2004. Results for the lower are good. I had a lot of fat and puffiness that were removed. However, I have been unhappy with the upper lid results from the beginning. My left eye has a visible surgical scar on the outer edge, which the doctor told me would fade over time. It has not only not faded, but it now looks even deeper because of my brow slowly drooping. In addition, the extreme hollowness, especially near my nose makes me look older than 53. I hate the sunken look. Do you think fat grafting would help or hurt? I am worried about having another procedure that could produce yet another visible scar. (The After photo is from today, and the Before photo is from almost 6 years ago, so of course there is other aging taking place in the After photo.)
Los Angeles Facial Plastic Surgeon

Other people I know who had procedures by this doctor were happy with the results. I was not happy with my results. I think he's retired now.

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Is anyone still interested in recruiting doctors ( in southern California) to try this orphan procedure of orbital fat replacement? I have some names of top ocuplastics at UCSD and UCLA we could all try writing. We could ask if they would start considering doing this approach. I know they are busy, but somebody needs to pick up the ball on this neglected area of plastic eye surgery. I have had fat injections in other areas and am quite pleased withe the results.
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I was unaware of ripoff .com, but have posted on MAKEMEHEAL,RateaMD and Complaint board. Adding photos when possible and always allowed to give and post doctors name. Perhaps these doctors have someway gotten to these Sights when there name's are printed. However, i have always challenged the doctor who did this to me, and also wrote to her and have had back and forth blogs with her former patience whom defend her or loyal Staff posing as them.Some posts appear on here and I've never said she was not good in other area's, but not eyes or face-lifts.Mine is not the only bad review.

 I will always hold my ground and photos are my best tool. You don't have to be a Rocket Scientist to see the negative difference.

I'm sorry you joined the ranks of bad P.S. Unfortunately there are more of them in the phone book than Attorneys. Not all are good at there profession. Years of experience and skill are  needed, and some never get it. Others are good at certain area's, but will not just specialize in those as they should.

They face little in consequence, so until the Legal System and Medical Boards start to hold them more responsible, botched job's it will continue.And the emotional depression,Loss and PTSD that follows are ignored.

I understand your wanting to fix a problem ASAP. It is difficult to look in the mirror. But time is sometimes the best way proceed. It gives you a chance to explore all possibilities on revision, review there outcome, and not rush into more surgery that can leave you worse off, with more scarring. Many on here have done just that and end up worse than before.

Also, if you jump from doctor to doctor in a frantic panic, then unhappy with his work and go to another. All your records are usually forwarded, and they will without your knowledge mark you as a Nut Case. "Unrealistic Expectations" are one of  their favorite comments, and saves them from any repercussions legally. Next thing you know, you can't find a P.S. good or bad to see you. Your blacklisted. Sad but true.

I'm interested in any photos you have, and all I can say is move slowly, let this last revision heal. Actually I would think a year is long enough, but don't expect a P.S. to tell you this if he thinks your ripe for the pickings.

It is a Profitable Business. Some earn more annually than Cardiologist or Obstetricians..  I've read marketing reports, only P.S. receive and the strategies are there to get your money with little risk to them

.Injectables were a P.S. Dream, with little risk or so they thought until they started full face injections and found woman looking like a lop- sided sponge in three months time when absorption started to occur.The Marketing on it today is still Big Business, and not always informed of risks.

 Your best interest is not always there top priority. However, there are a few that are in this for the skill. Some even do pro bono work, and those that cannot help, will be honest and say so. Like I've said, word of mouth and these Sights are best and skill in that facial area needing revising.

Eyes are the hardest, so once there screwed up it is a on going battle, but your not alone in that boat.

Keep me informed and let me know once photos are posted.
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Yes it is clear that aggressive surgery was preformed. I know too well and we all become twins with the results. Doll eyes in appearance, no expression, wide and rounder eyes. Over time they will become more hollowed and sunken. Aging you, not enhancing your appearance.

Unfortunately, these unskilled physicians have little to lose, except for these sights where it is so important to post photos, write your reviews and WARN others.


I still say fat pearl grafting or grafting where Small incision is made and fat cells are laid into that area is best. It is minimal invasive, and for me, after two years has left better results than injectable. Some has absorbed, but more was left after this procedure. Also the lateral mid lift helped reshape my eyes back to the almond appearance they once were.

Aggressive surgery always leaves them round, wide and empty. Truly takes your genetic eyes away. And that should be considered" Negligence".

A skilled surgeon would never preform the cookie cutter standard surgery on everyone because everyone is different.Only if your lids are so drooping they interfere with sight, however, others are based on need and always bring a photo of your youthful eyes. A picture speaks a 1000 words.

Hindsight for me today, but also why I'm here.Too inform.

Remember any revision is not a one time fix. Several grafting are needed so find a skilled surgeon, let him know, you know,one isn't going to cut it and work out an on-going program. Every 6-8 months or annually. Making sure enough time has passed from previous procedure for healing and better idea of what is needed now.

You may pay anywhere from $1,500 to $3,000 first trip, but others can be worked out and much less in costs. Don't be fooled by high priced  Doctors, they all put there pants on like you and I.  Normally it is there overhead you pay for, not necessarily skill. So ook for skill, and word of mouth. All photos in there office are of course from great outcomes. I'll bet you find mine in my original surgeons photo album.


My positive thoughts are with you. New treatments come along all the time. You don't have to settle for this blotched surgery and law suits have been won for woman that eye's do not close after these aggressive surgeries. Never hurts to seek out legal advise, file claim at Better Business Office and Write your reviews on as many Wen Sights as Possible, warning of this physicians unskilled outcome.

 Awareness, although slow, is coming. Always NAME your doctor. I will never stop telling people" Victoria Vitale Lewis", From Melbourne ,Fl.  Changed my life to a negative, created depression and mourned  loss of my identify for many years. She has never admitted wrong, cared about my devastation for one second, and her life did not skip one beat.

Keeping silent, and accepting what is non acceptable, is the worst thing you can do when you wake up and see a stranger in the mirror.

Good Luck
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I agreed with everyday you said. It is very hard to trust any surgeon. I had super bad eyelid surgery too. This site wouldn't let me tell who done it to me. I found out from my research on the internet that there were other complaints about this doctor too. These people aired their story on complaint boards or ripp-off dot com and plastic surgery review boards that this doctor is not on. And the part about pictures and testimonials can be fake cuz we don't know who these people are. It is the same like celebrities endorse a product they they don't use.
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You should post on all possible sites about the surgeon that done this to you. In Gods eyes, you done the right thing to warn people. I will post my photos soon so people can see my burn skin and terrible upper and lower eyelid surgery by Dr. W. of Newport Beach. I was told that several plastic surgeon to wait from 1 year to 1.5 years to do revision. This idiot put pleats onto my lower eyelids and gave me crow's feet which I never had before the surgery.
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Yeah it is visible the aggressive surgery left that wide eyed, Doll appearance. Hate it, because it really takes your personality, softness and leaves this empty hollowed appearance. Trust me I have suffered with this stranger in my own mirror.
I'd seek Pearl grafting. Adding fat back into your lids is the only non-invasive and safest way to go. It is not a one time fix, and I have read some woman have had that with other things, like my mid-lift to gain that softness and expression back.So be prepared for several grafting's. Find a skilled surgeon and make it clear your aware this will be on-going. I'd work on a reduced charge since they are anywhere from $1,500 to $3,000 a pop. Continuing grafting can be done at lessor charge. You can have it done annually or every 6-8 months, making sure enough time passes in between for all healing to occur and a better idea of what will remain.
It has been two years come June for me and I still see fullness. Not as much, but better than any injections or before the grafting. The lateral pull mid lift also helped reshape the almond eyes I once had. Aggressive surgery on upper lids leaves your eyes rounder and you lose your genetic formation.
Keep me posted and my thoughts are all positive for you.
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Thanks Vicksue for your comments. I just posted a photo of my eyes and a question about Doll's Eye condition. Should be up in a few days.
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I hate to say this. But your pre-surgery picture make you look a lot younger. I don't see why u think u need eyelid surgery. You kind of remind me of Alana Stewart (Rod's ex-wife).
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VickSue above says:"This is a skilled procedure with only one surgeon to my knowledge that does it on a regular basis. Dr. Meronk in California. However, even his reviews are hit and miss. Long Term results are not available and second and third procedures have had to be done with more than one patient. If done without skill you can end up with a worm like piece of tissue implanted in upper lids that are visible and not natural looking to others. With little volume restored and it is an invasive procedure so more scaring. By the way, his charge is $8-10,000 per pop,via last inquirery. Fat pearl grafting is a similar procedure. Results again are not long term. Then there is fat grafting or injections. To me this is the best way to go, but again a skilled surgeon needs to be found."

Dr. Meronk in Oxnard has just retired. So who will take up the cause for this "orphan procedure?" He says it takes 2 hours with local anesthetic. And you say he charges $8,000 to $10,000? Yikes. Sounds real profitable to me and he is offering an 8 week online course to qualified docs per his webiste.
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Wow.I was unaware of his( Merok) retirement. As stated, I have seen reviews where this procedure has been ineffective. I still beleive in Fat transfer, with a skilled surgeron in this area, since eyes are such a delicate, limited area to work. His quoted charge to me of $8-10 grand was in 2008.
I have no clue what this procedure would cost today, or worth it's attempt. It too can require more than one attempt, and invasive, leaving scaring in an area very obvious to others. Make up does not cover scares.I think an on line course for the best surgeron, is not enough for me. Dr. Lia also showed on line his full facial fat injections, and always viewed as a visiual for patients, certainly not an educational training tool for M.D..
We then become the hit and miss try outs, dummies, and that doesn't sit with me.
There are thousands of P.S. out there, so if one retires, I wouldn't stress to much. Seems to be more than enough to take there place. Finding the right one is another matter.
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I asked a board certified plastic surgeon in San Diego about Meronk's pearl fat method for treatment of doll's eye condition and he said it was just too specialized for him to divert his efforts away from the mainstream procedures such as the injection of fat. That fat injection is almost a no brainer surgically and makes lots of money but very little of it survives. Meronk's approach with the fat pearls and the strips of fat gives far more structure to the graft. Retired Dr. Meronk still hasn't convinced any other doc to do this and is now charging to access his full website. It is really strange and leaves a bad taste in my mouth, since it is difficult to get the point of what he does without all the photos. I had made copies of some pages before he did that and was trying to convince the doctor and others of the efficacy of the approach and they just didn't get it even with all the photos there. The site is almost useless if no one does the surgery, so I don't get why he thinks its worth $50. Plus, most people are skeptics and will not pay the extra money to get into the site.

Sadly, fat injection will never address the hollowness known as doll's eye. A good example of this condition Meronk terms the doll's eye is seen in the actress who play's Diane the managing partner on the TV show the Good Wife. It is dangerous to inject fat or anything that close to the eye and most plastic surgeons view pearls of fat as the WRONG WAY. All they think is "lumpy." I think the photos I remembered seeing before he blanked out so many photos looked way better, but who knows if the results were as they say "durable."
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Don't feel that bad about Dr. Merronks retirement. Many on this Web sight have gone to him. I had an e-mail consultation and for a risky chance, decided it was way to expensive.

Although he has had some success with his Pearl-Strip Grafting,in most cases they did not last. I never saw photos of patiences after 6 months or even 2 years. The strip of fat  can harden and the fat injected around them absorbed, leaving a worm like piece of dead tissue on upper lid. This  has to be removed.. Leaving more scare tissue.

All Plastic /Reconstruction Surgeons are going to show only there best and most successful treatments.


I had just Pearl Fat Grafting, where a small incisions is made, and fat cells are deposited into them. I've had both injections, which do not last, and Pearl which is still visible, but some has absorbed.

Any object, even your own tissue is automatically rejected from your body, needs much oxygen for the cells to take on life and regenerate.just like with the cells alone. Rejection and dead tissue are more likely the outcome.

 Pearl grafting the same, but much less invasive. This method although not all that new, is still being perfected annually

.Not one upper lid revisioni s a one time fix and those that say they are , are not telling the full truth.

Keep searching or go with Pearl Grafting, but improvement and advancements are around the corner .Don't give up and go with common sence, and education once deciding to enter into any revision.
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The top photo is the before and the bottom photo is after the surgery.
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Hayley's mom,
I agree with you. You looked better before. Hope it has improved with time.
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OMG! You look fantastic! I would have never noticed the "hollow" area or the scar if you didn't mention it. Trust me, leave it alone. You look 20 years younger. It was worth it, your lucky.
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OMG! You look fantastic! I would not have noticed the "hollow" area or the scar if you didn't mention them. You look 20 years younger... seriously.
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Abstract Purpose: The purpose of this study is to present an alternative procedure for rehabilitation of the volume deficient anophthalmic or enophthalmic socket. Methods: A retrospective review of clinical and photographic records of 12 patients with either an anophthalmic or enophthalmic orbit (14 orbits) undergoing volume augmentation by micro-fat grafting, or lipostructure, as initially described by Coleman. Patients with orbital volume deficiency seen in the oculoplastic clinic at Chelsea and Westminster Hospital, London, UK, were invited to participate in the study. The technique is discussed in detail. Results: The volume of fat injected ranged from 0.8mL to 4.5mL (median, 3.05mL) per orbit, with a median increase in exophthalmometry measurements (available in 9 patients) of 2mm (range, 0–7.5mm). Subjective improvement in cosmetic outcome was experienced in all patients. Repeat grafting was required in 1 patient, and will be required in another patient. There were no embolic complications. The procedure was well tolerated in all patients. Median follow-up was 14.5 months (range, 12–30 months). Conclusions: Micro-fat grafting to the anophthalmic or enophthalmic socket appears to be a safe alternative technique for orbital volume enhancement. It has the advantages of avoiding alloplastic infectious complications, ease of technique, minimal donor site morbidity, acceptable graft take rate, low embolic complication rate, and good cosmetic outcom
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Hello, I see what you are saying and this is a common problem with aggressive upper eye lid surgery. I too had same results from a surgery done 9 years ago. It aged me as well instead of giving me the younger promised appearance. I was talked into the upper lids, and really did not need them done. Surgeons are marketing there practice like anything else.Cosmetic surgery is BIG BUSINESS. I have read medical issues on marketing techniques provided to them for increasing there profits and selling you the goods. It is a big money deal with plastic surgery. Mate that with enormous ego's, faithful staff and you have a recipe for a fine plastic surgery business. Unfortunately, not all surgeons are equipped to perform these surgeries. This is an area that requires much skill.Not just paper and certificates hanging on there walls. Time does not help with a botched eye job, only add to the aging. Skin and tissue recede with age, so the hollowed sunken look only gets worse over time. As far as reversions, well I've spent most of the past nine years researching this area. There are many surgeons out here that claim they can do the job. Be careful, there ego's are bigger than there skills in most cases. Everyone with this problem may have some similarities, but with different degree's of issues. Depending on your original surgical outcome. Our skin,age and degree of hollowness are all factors. What works for one may not work for you. None of the procedures for reversion are permanent. All need some kind of reversion, or second, third application. As sad as it is,it is much easier to remove fat and tissue than replace it with any permanency. Also know, you will "NEVER" look the same as you once did. Keep your expectations low, and for me some fullness, and more softer appearance is all i could ever hope for. My once model appearance went into the hazardous waste container. Whats available? Fat strip grafting. This is where a strip of fat is taken from donor area and planted into your upper lids for volume and fullness with the hopes it will transplant into your lid and with the aid of fat injections,takes off and grow cells and tissue. This is a skilled procedure with only one surgeon to my knowledge that does it on a regular basis. Dr. Meronk in California. However, even his reviews are hit and miss. Long Term results are not available and second and third procedures have had to be done with more than one patient. If done without skill you can end up with a worm like piece of tissue implanted in upper lids that are visible and not natural looking to others. With little volume restored and it is an invasive procedure so more scaring. By the way, his charge is $8-10,000 per pop,via last inquirery. Fat pearl grafting is a similar procedure. Results again are not long term. Then there is fat grafting or injections. To me this is the best way to go, but again a skilled surgeon needs to be found. Good luck with that without travel. Micro fat injections is when small amounts of fat are injected back into the lid for volume and hope the cells will take on blood flow and survive, growing new fat and tissue. Even with skilled surgeons whom perform and know the best methods of harvest and injection, keeping as many cells viable as possible, you need more than one procedure. I personally think you need as many as it will take. In this case less is more. You do not want allot of fat injected into an area that is already lacking fat, thinner skinned and can lump making your percent situation worse. Small amounts at each procedure. Then wait and see how much remains and how much absorbs into your body. Generally 20% remains. Then have it done a second time, even third if necessary. You can be put under with local antithetic for this but the cost still may very. I have read where oxygen is the best source of getting blood flow, circulation to the cells and maintaining viability for life with those that survive. I would ask about using oxygen before and after this procedure. It can't hurt. This is what I would choose to go with, but again finding the skilled surgeon is the tricky part. I will post the information i have on micro fat grafting. Although it states only few needed a second try, I had it done 6 years after original surgery and only 10% remained. I would need another additional 1-2 tries, and travel is necessary. Cost for reversion can become more costly than original surgery. For lower lids, filler can help, also mid face lift. Again you are working in a delicate area so you must use caution.Blindness has been know to result in this area of surgery. None of these methods are guaranteed and can actually make you look worse if not done with the up most care, experience and skill. Good Luck
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I do see what you mean. The uppers near the inside of your eyelids do look hollow. I have no idea what to do to correct that, but go to a PS for eyes only and get a recommendation. I wonder if they could inject something in there? Not sure, b/c the eye is a tricky area. I'd go to the TOP people you can find and get at least two opinions before you do anything about it. You don't want to do something that will make the situation worse.
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