Lower Eyelid Surgery and Fat Transfer Approach Gives Impressive Results

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In the past, blepharoplasty, or more commonly referred to as eyelid surgery, involved a rather over-aggressive removal of skin and fat.  However, this approach often left the patient with a stereotypical “plastic surgery look” and in some cases lid retraction and other complications that affected its function.

But nowadays, the “focus” is to preserve enough soft tissue to avoid surgical stigmata and thus create results that look not just rejuvenated but also natural.  Hence, many surgeons today do recognize the importance of structural fat transfer in three-dimensional facial rejuvenation procedures.

In the case of lower eyelid surgery, instead of removing the entire herniated fat that causes the “puffy” appearance or “shadowing,” a more ideal approach is to remove just a small amount and/or transpose the excess fat to create a smooth lid-cheek junction.

Occasionally, fat transfer or fat injection is performed to further create a smoother transition between the lower lid and the upper cheek.  

Fat transfer is also helpful in correcting the appearance of deep tear trough.  While traditional fillers such as Restylane can also accomplish such goal, most patients require 2-3 touch-ups every year so in the long run they are actually more expensive.

Fat transfer, meanwhile, provides results that can last for many years.

When fat transfer is combined with lower eyelid surgery (or facelift), the results are expected to be more stable and tend to last longer compared to skin excision/internal suturing techniques alone because it enhances soft tissue support.

Relying solely on the internal support measures and skin excision, particularly when they involve over-aggressive maneuvers, may distort the natural anatomy and shape of the lower eyelid.  For this reason, fat transfer is no longer viewed as an afterthought but rather as a critical part of most eyelid lifts. 

Article by
Beverly Hills Plastic Surgeon