25-34 year old woman treated with Eyelid Surgery

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A 28-years-old Australian came to our plastic surgery office for consultation regarding a groove bellow lower eyelids and “puffiness” of lower eyelids. This condition gets worse after few drinks or spicy meals. She stated that she had this condition possibly since her early teens.

On clinical presentation she demonstrated moderate groove (tear trough) separating cheeks from lower eyelid and mild fat bags underneath lower eyelid. This condition is most likely related in part to her weak (hypo plastic) cheek bones as well as lack of fat tissue in deep and superficial compartments of the cheek (left).

In local anesthesia with mild oral sedation (to decrease anxiety) we performed lower eyelid surgery trough a small incision placed inside the lower eyelid. Fat tissue that created mild bulging (bags) of the lower was distributed over cheek bone underneath the tear trough groove. Small amount of fat grafts was harvested from her lower abdomen and injected into deep and superficial fat compartments of the cheeks to augment cheeks and eliminate the groove entirely (right). In a young person like this fat grating needs to be repeated every 2 years. A small cheek implant could have improved this condition as well.

Before lower eyelid surgery and fat grafts (left); 1.5 years after lower blepharoplasty (transconjuctival) and cheek augmentation with fat grafts (right).

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