As I Have Already Had Fat Compartments Removed, Am I a Candidate for Arcus Marginalis Release? I Am Confused.

Lower bleph was done years ago. Now the under eye area is sunken and dark.

Doctor Answers 7

Fat already removed, whaty about arcus marginalis release.

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Don't feel bad. Not only are you confused but so are a lot of surgeons. While it was standard practice to remove fat years ago, we unfortunately still see a lot of surgeons doing that. However, after the fat has been removed and the hollow look has begun, you are not without options. I have been performing a lateral access muscle lift with fat transposition or fat grafting to rejuvenate patients such as your self. This prevents further resection of skin or muscle , lifts and supports the lower lid, and allows volume to be replaced with fat grafting. I would not get too caught up in the technical aspects but would seek a surgeon who has had success in patients with issues such as yours. I used to practice in your area at Ochsner in New Orleans and you have some excellent surgeons in your area. I would recommend Dr. Von Graham at the main clinic in N.O. I wish you all the best.

Birmingham Plastic Surgeon
4.6 out of 5 stars 13 reviews

Most likely not.

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That fat that was removed is what is used as part of arcus marginalis release.  The fat in the lower eyelid is dissected and positioned into the top of the cheek to help fill the tear trough hollow.  Standard lower blepharoplasty does not save this fat, which gets discarded.  So no, unless you have significant retained lower eyelid fat, no you would not still be a candidate for arcus marginalis release.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Not satisfied after lower eyelid surgery

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It is unfortunate that you are not satisfied after lower eyelid surgery.  The lower eyelids are complicated from an aesthetic perspective because so many factors need to be considered such as texture and quality of the skin, prominence of fat, position of midface structures, relative position of the eye itself with regard to the eye socket, strength of the tendons that support the eyelid, to name but a few.  Some of these conditions are corrected with surgery, others with lasers or related devices, and still others with injectables (e.g. fillers).  If you are not satisfied with the appearance of your lower eyelids I suggest you consult with someone who has expertise in all of these areas in order to develop a plan that is most likely to help you meet your needs.  Best of luck.

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 43 reviews

As I Have Already Had Fat Compartments Removed, Am I a Candidate for Arcus Marginalis Release? I Am Confused.

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       The sunken appearance can likely be improved with fat grafting or filler placement. 




Kenneth Hughes, MD Los Angeles, CA

Fat grafting and lower lids

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Your lower lids are sunken in because too much fat was removed. These days we conserve fat and reposition it where it is needed.You would benefit from fat grafting or a filler in the lower lid area.

Fat removal precludes arcus release

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as you must have bulging fat to benefit from the arcus release.  If you are hollow and without large bags, you may benefit more from dermal filling or fat grafting.  My own preference for lid surgery is preservation of fat and arcus release.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Have Dark sunken Circles under the eye after Bleph?

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I would visit with a surgeon who understands lower eyelid the past volume/fat removal was taught, these days PS practice volume retention, in fact fat grafting is very common for all types of facial surgery..visit with a BC PS and discuss your options.

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.