Arcus Release and Fat Grafting (Open Fat Grafting) Doctor Recommendation

i am Asian and I have dark circles under my eye. I'd like to do arcus release and fat grafting (open fat grafting). Are there in europe doctors who do this same treatment?

Doctor Answers 4

Arcus Release and Open Fat Grafting is the best Dark Circle technique-If done without Arcus Release you will get puffy eyes

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The depression beneath the lower eyelid called the dark circle under the eye is caused by the attachment of the Arcus Marginalis which holds the lower eyelid skin tightly to the bone. This allows the skin and fat of the lower eyelid above the Arcus to fall over and create a shadow-the Dark Circle.

I release the Arcus Marginalis and place a Fat Graft under direct vision beneath the arcus and thus plump the depression beneath the lower eyelid and lessen the Dark Circle.

Attempts at injecting fat typically fail because the Injected Fat is forced above or below the Arcus Marginalis attachment resulting in either puffiness of the lower eyelid, or fullness below the Dark Circle which worsens the Dark Circle

No need for an arcus release with fat grafting.

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There is no need for an arcus release with fat grafting.  In fact, I find it to be problematic because the fat placed in microdroplets stays where I place it better than if the whole area is cut open and fat placed like big balls.  In addition, I do a micro release of the arcus when I am doing this because every pass of my fat I can literally feel the arcus giving way because that is the plane I place the fat into.  I truly believe this is sufficient if you review my work.  Plus, I believe fat grafting is much more beneficial if you artistically to blend micro areas of the face, areas that you are probably not bothered by since you may not look at the non-obvious areas but these areas can be critical to achieve an overall balanced result.  I have attached my keynote address in Belgium last year.


Dr. Sam Lam

Sam Lam, MD, FACS
Dallas Facial Plastic Surgeon

Fat Transfer to Improve Bags Around the Eyes

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Fat transfer to rejuvenate or improve the appearance of lower eyelid bags is a common procedure performed in the United States, Europe, and elsewhere in the world.  This procedure is usually performed by plastic surgeons who have experience in the specific techniques of fat transfer/grafting and are comfortable with the anatomy and aesthetics of the periocular region (i.e. the area around the eyes).  The specifics of the technique to improve the appearance of lower eyelid bags is to release of the arcus marginalis, open of the orbital septum, and redistribute the orbital fat over the lower bony orbital rim.  In addition to this, fat is then harvested from other areas of the body and injected around the eyes (i.e. lower lid/cheek junction, cheek bones, and sometimes lower face creases) to add volume and restore a youthful appearance to the eyes and face.   

Jaime Perez, M.D.,

Plastic Surgeon Specializing in Lower Eyelid Surgery

Plastic Surgery Center of Tampa, Tampa, Florida

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 81 reviews

Micro fat grafting to lower eyelids with arcus release

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This is a procedure that is relatively common. Dr. Verpaele in Belgium frequently contributes in this forum and si very experienced with microfat grafting in the face.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 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.