Does lower bleph always cause hollow eyes?

Question

Just interested to know from those with a lot of experience: do patients who undergo lower bleph with only fat removal always report hollow eyes in the long run?

Tanveer Janjua, MD · Answer

Fat removal has to be done conservatively during lower eyelid blepharoplasty.  As long as it is done in a conservative fashion it is very safe and in the long run will not lead to any hollowness of the lower eyes.  The key is to remove just the right amount of fat so this is not excess fat left behind and not too much is removed either.RegardsDr. Janjua

Mehryar (Ray) Taban, MD, FACS · Answer

There are always exceptions to the rule but usually lower blepharoplasty fat removal will cause hollow under eyes, either early on or it manifests as someone gets older.  That is why when I perform lower blepharoplasty, I preserve the fat and reposition it.  The exact technique is transconjunctival lower blepharoplasty with fat transposition. That is different from fat injection. See link below.

Adam Scheiner, MD · Answer

Dear Patient from New York,Lower eyelid surgery to remove or reposition fat under the eyes if done with finesse can give natural rejuvenation without issues of hollowing. Its best to seek out surgeons with great experience in lower eyelid surgery such as an Oculoplastic Surgeon in your area.I hope this was helpful.

Jeffrey M. Darrow, MD · Answer

Hollow eyes are not the inevitable result from a lower blepharoplasty.  If fat is removed from the lower eyelids, it should be contoured to establish a smooth lower eyelid surface.  The object is to improve the contour, not to remove as much fat as possible.  If fat is repositioned into the tear trough, it helps to fill the tear trough and create a smoother lower eyelid contour.  See a board certified plastic surgeon to discuss this in detail.

Steven Wallach, MD · Answer

A lower bleph can hollow the lower eye region if over treated.  One can also use the fat in the lower lid to camouflage the lower lid cheek junction.

Sean Freeman, MD · Answer

j k, lower lid bleph surgery with fat removal or repositioning can lead to a hollow look under the eyes and should be avoided in most patients. See someone who is familiar with a "SOOF lift blepharoplasty" and you will not have this problem. Search the Internet and look at photos. Good luck!

Rick Rosen, MD · Answer

No it should not.  Conservative removal or repositioning of fat will improve the appearance of the lower lids without a hollow look. Removal of too much fat may lead to that appearance. Rejuvenation of the lower eyelid region is the goal.

Daniel M. Calloway, MD · Answer

Lower eyelid blepharoplasty is designed to restore the natural youthful appearance to the lower eyelids.  The goal of the surgery is to restore the ideal contours to the lower eyelids, rather than just remove fatty tissues.  Lower eyelid "bags" occur because the normal fat that lies in the orbit (eye socket), can bulge through the membrane called the orbital septum.  This is known as psuedoherniation of the fat compartments.  Appropriate managment is to remove or reposition the fat to avoid the postoperative hollow eye appearance as well as to structurally reinforce the orbital septum to prevent recurrent bulging.  Eyelid position, support, contour, symmetry, skin laxity and wrinkles all must also be corrected at the time of surgery.Since each patient presents with a unique set of "problems or concerns", each surgery is meticulously taylored to the individual.  If a surgeon tells you that "I always do the surgery this way" suggests that the surgery is not customized to the individual, and less than ideal results may occur.A consultation with an Oculoplastic Surgeon will help you decide what surgery is best for you.Good luck!

Robert Savage, MD (retired) · Answer

Obviously most patients don't get hollow eyes after a lower bleph,otherwise the procedure wouldn't be so popular.However it is one of the postop possibilities especially if too much fat is removed,also depends on your age,preop eyelid structure and contours and sometimes medical illnesses

Brooke R. Seckel, MD, FACS (retired) · Answer

No. Hollow eyes after blepharoplasty occur when too much fat is removed-most experienced eyelid surgeons do not do this.In addition the modern trend in eyelid surgery is fat grafting or transposition which preserves lower eyelid fat. For more information please read below:

Does lower bleph always cause hollow eyes?

Answers (10)

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