When you have lower bleph with fat repositioning, can fat be moved back up? I don't care if it doesn't go back perfectly

Question

I had lower bleph with fat repositioning. The results are pretty devastating. I now know I was not a candidate for this surgery. I am very hollow under my lash line and to the sides of my eyes. The fat seems to be placed below my orbital bone resulting in a shelf. I have no natural under eye contour. I just want the fat moved back. Even if it isn't perfect.

Kenneth D. Steinsapir, MD · Answer

So please take what I am about to write with a gain of salt. The likelihood of reversing this surgery without causing harm is low. Looking at your picture, there is likely very little transferred fat in the top of the cheek. You did not indicate when you had surgery but these surgeries take time to heal. I am going to guess if I had seen you before surgery, I would have advised against surgery and in favor of a carefully performed under eye filler service. I suspect that is the best option for you still. Don't get further harm from a well meaning surgeon. Preserve what you have that is great. I would encourage you  to get some opinions from surgeons  like me who fix botched eyelid surgery. Less is more. Also this consultation can not be performed over Zoom so be skeptical if that is offered to you.

Marc Polacco, MD · Answer

Thank you for your question. I'm sorry you're going through this. One thing to consider is timing. Over the course of the first year, some of the fat transferred will shrink. In fact, most surgeons overcorrect initially in anticipation of losing volume over time. If you're over a year out, yes it is possible to move the fat back into the original position. Again, I'm sorry you're going through this, and I wish you all the best.
-Dr. P

Harold J. Kaplan, MD · Answer

Hello DM.  It does not appear that there is excess fat under the eyes.  It appears that you have hollows directly under the lashes where the fat around the eye is receding.  This is a very common sign of aging and we use Restylane injections to correct it (see link below).  The procedure is quick and easy and gives you 1-3 years of duration.

Brian K. Machida, MD, FACS · Answer

I still see bruising around your eye. You should give it more time as some of this may be localized swelling and may recede.

Alon Kahana, MD, PhD · Answer

Hello. The lower eyelid fat pads can be repositioned or debulked (or both) to correct a complication from prior surgery. This needs to be weighed against the risk of complications. An in-person evaluation would be essential.

Camille Cash, MD · Answer

I'm sorry to hear of the issues you are having since your blepharoplasty.  It's difficult without an exam or photos to recommend specifically what may improve your results.  You may benefit from fat grafting to the hollow areas. I recommend visiting with a board certified plastic surgeon for an evaluation.

Robert T. Buchanan, MD (retired) · Answer

You are clearly not a candidate for any further surgery. What you need now is probably what you needed before the surgery, addition of volume to the under eye area. You can accomplish this with either fat grafting or use of a filler. Thankfully the modern fillers are frequently quite long lasting. Either needs to be done by an expert plastic surgeon with significant experience in augmenting this area.

When you have lower bleph with fat repositioning, can fat be moved back up? I don't care if it doesn't go back perfectly

Answers (7)

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