Arcus Marginalis Release, Fat Grafting Permanent Under Eye Solution?

Is arcus marginalis release in Blepharoplasty, and Fat grafting a permanent solution to correct dark circles and hollowness under the eyes? With this procedure, do I need to do fat grafting a few times a year after the original procedure? Thanks.

Doctor Answers 4

Arcus marginalis release and fat grafting are entirely different operations.


With arcus marginalis release, we are able to redrape the fat in your eyelids to correct the hollowness. With fat grafting, we correct the hollows with fat from another part of your body. So they are different concepts, and they are not done together.

Both procedures work well, but they are both technically difficult, and the results are quite variable.

In NYC, we use arcus marginalis release or fat grafting when doing lower blepharoplasty, depending on the anatomy of the patient.

With fat grafting, the result you see at 4 months is the final result. At that point we do a touch up on 10% or 20% of our patients. But you do not need to keep repeating it. HOW fat grafting is done is really key.

For most patients, once the hollowness and bags are corrected, the "dark circles" are no longer an issue.

Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Options for lower eyelid rejuvenation

You would be a candidate for a  lower eyelid  blepharoplasty.    If you have herniation of orbital fat causing bags of the lower lids with lack of soft tissue fullness.  These features can be corrected with a lower eyelid blepharoplasty with fat repositioning.  An accurate diagnosis of the problem is essential.  .  If the condition is only lose skin then you may want to consider SmartSkin or  SmartXide microablative fractionated CO2 laser resurfacing.   A consult would be needed to advise you which procedure would meet your expectations.  Other choices would include soft tissue fillers such as Juvederm.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Blepharoplasty and Fat Grafting

The arcus marginalis release and subsequent fat repositioning is a method of distributing fat along the orbital rim in order to soften the visibility of the bony outline. The ultimate result or goal of this approach is to shorten the lid-cheek junction and blend the lower eyelid with the upper cheek. The same result can be achieved by taking fat from another part of your body and injecting it along the orbital rim. This is a fat transfer. In my practice, we do lots of fat transfer along the orbital rim and get very nice results accomplishes this goal. As far as dark circles go, if the dark circles are related to a shadow from a hollow under your eye, it will improve. Good luck. Our website has many examples of these procedures.

Amir M. Karam, MD
San Diego Facial Plastic Surgeon
4.6 out of 5 stars 114 reviews

Dark Circles

I hate to be the bearer of bad news but fat grafting may not help. The dark circles are caused, mainly, by the visibility of blood vessels through thin skin. However, cheek descent in conjunction with lower lid fat pseudoherniation can lead to light reflective changes that worsen the appearance. I prefer arcus release with fat redraping. This reduces the pseudoheriation and corrects the rim/tear trough deformity. I really don't know about fat grafting the lower lid. You may also need midface elevation to fully correct the deformity.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
4.4 out of 5 stars 33 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.