Artefill, Fat Grafting or Other Treatment? Post Blepharoplasty Hollowness

I am 42 years old, and had upper and lower eyelids done 9 months ago. I am not happy with the final result- too much skin removed- eyes look hollow and skeletonized, dead and expressionless. I am very eager to fix the problem but do not want to make another mistake which I will regret later. Which is the best treatment for post blepharoplasty hollowness? Artefill, Fat grafting or other treatment? What are the chances of the correction procedure going wrong? Many thanks

Doctor Answers 5

Fat Grafting for Correcting upper eye hollows post blepharoplasty

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Many of my brow-upper lid junction structural fat grafting patients have come to my practice for the correction of hollowness created by the over-zealous removal of fat during an upper blepharoplasty surgery. I am continually amazed at how many cosmetic surgeons practice 1970's-era blepharoplasty surgery in the 21st century. I almost never remove upper lid fat during blepharoplasty surgery, and in many cases I actually add fat at the brow-upper lid junction. Fortunately, essentially all cases of post-blepharoplasty hollowness can be improved dramatically by structural fat grafting. It is a more challenging procedure, as scar tissue must be overcome to create space for the grafted fat, and in many cases it takes more than one fat grafting procedure to restore adequate fullness in these patients.
Lower lid hollowness following an overly aggressive lower blepharoplasty can likewise be improved. One must exercise care and caution, as lower lid skin and the underlying soft tissues are usually quite thin, and thus the lower lids are less able to conceal grafted fat. Fat grafting must be preformed conservatively here, with a plan for secondary and occasionally tertiary fat grafting procedures depending on the 'take' of the initial fat grafting surgery.
Many patients referred to me for treatment of these frustrating and difficult post-blepharoplasty problems have reported more than just a cosmetic improvement. Excessive removal of skin and fat during upper and lower blepharoplasty can impair normal lid function and cause or aggravate dry eye syndrome. In some cases the fat grafting procedure will restore suppleness and flexibility to peri-orbital soft tissues, make eyelid closing easier, and improve the truly irritating and aggravating symptoms of dry eye syndrome.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Upper lid hollowness

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Thank you for your question and for sharing your experience.  Non-surgically, Restylane would be my first choice.  If you like the results and want something more permanent, then fat grafting can work.  I would use the same plastic surgeon for both since they will get to know your anatomy and how you respond to the Restylane if you chose to start with a non-surgical approach.

Fat Transfer

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I like Restylane for this, or Juvederm. Thank you for your question and good luck with everything.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Eye hollowness correction

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I would recommend you stay far away from permanent artificial fillers such as artefil, as you will near certainly experience negative consequences in your lifetime.  I commonly see patients with your condition in my clinic for correction.  I feel that fat is by far the best filler of all and yeilds the best and longest lasting results at the price of a bit more recovery and swelling.  For a quick fix any Hyaluronic acid based filer is safe and effective.  I use Juvederm in my practice because of high quality standards and a long history of patient satisfaction.  I hope this helps!  

All the best,

Rian A. Maercks M.D.

Fat grafting to rejuvenate the eyes

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Aging is in part volume loss and much of this is fat loss.  Since most of the energy of our appearence is centered around our eyes volume loss in this area can have a particularly aging affect.  The defect of you upper eyelid/eyebrow area is called an 'A-frame" deformity since it looks like the shape of an "A" and it is a direct result of insufficient fat in that area.  The thinne the are where fat is to be grafted the more likely it is that you will need more than one session.  Make sure you choose a well qualified and experienced board certified plastic surgeon as achieving harmonious results in this are can be challenging.  Look at their before and after photos as this can give you an indication on what they have been able to achieve.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

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