Is it Okay to Combine Blepharoplasty with Cheek/Under Eye Fat Transfer?

I am deciding between getting a U/L transconjunctival bleph or that procedure combined with fat transfer to the cheeks and and perhaps under eye if needed. I have bags where fat needs to be removed and transposed. In addition, I have a very gaunt face (flat cheeks) and temples. Will the swelling from adding fat to my cheeks distort my eyes or stitches? Is it best to do the eyes alone, add fat later?

Doctor Answers 10

Simultaneous Blepharoplasty and Fat Transfer

It is not only possible but also advisable for you to have the two procedures simultaneously if you are considering both a blepharoplasty and fat transfer surgery. This way, you will only have a single recovery period and will not have to take off from work, school, or other obligations to rest and heal. Also, some surgeons offer a discounted rate for patients who opt in for more than a single surgery. This is something to discuss in person with the surgeon who will be performing your cosmetic procedures.

Manhattan Facial Plastic Surgeon
4.8 out of 5 stars 42 reviews

Blepharoplasty and Composite Fat Grafting are usually done at the same time

Thank you for your question. The answer is yes. I always do Fat Grafting when I do a Lower Blepharoplasty. I also do it through a laser incision on the inside of the lower eyelid called the Transconjunctival Blepharopasty.

Note I am talking about Composite Fat Grafting where a whole piece of Fat is harvested from the pubic area and grafted into the depression or hollow under the eye.

I am not talking about Fat Injection.

It is best to do the Fat Grafting at the time of Blepharoplasty so that the Fat can be positioned properly for best effect.

Eyelids and fat transfer

It is perfectly acceptable to do upper and lower eyelid surgery, including transconjunctival approach to the lower eyelids.  You could also do fat transfer or grafting all at the same time.  I would graft to the upper and lower cheeks and temples.  However, I would not recommend doing fat transfer to the lower eyelids.  This is relatively risky all by itself, even worse to do an eyelid procedure then graft on top of it.  The swelling would make the final result very unpredictable.  

John Bitner, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 87 reviews

Combining blepharoplasty and facial fat grafting is common

It is quite common to combine blepharoplasty with facial fat grafting. This is the preferable route for most patients as it saves on surgery costs and creates just one recovery period. In my practice I have not found fat transfer swelling to negatively affect the eyelid surgery results (or vice versa).

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Can a Blepharoplasty and fat transfer procedure be combined?...

A blepharoplasty and fat transfer to the cheek and eye area can easily be combined.  Using fat grafting under the eyes in addition to upper and lower blepharoplasty gives the hollowed areas under the eye and cheeks additional volume and improves the skin condition.  Fat transfer is done by gradualy building up the areas with multiple injections thoughout the year to reach the desired youthful appearence.  There will be some swelling from the procedure but it does not interfere with the blepharoplasty sutures.  Consult a baord certified facial plastic or plastic surgeon to see if you would be a candiate for this procedure.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 204 reviews

Fat transfer and blepharoplasty

This is a very reasonable surgical combination. There is no contraindication for combining lower lid blepharoplasty, open or transconjunctival, with fat grafting. Fat grafting and lower lid blepharoplasty both carry risks with surgery, so meet with a Board certified plastic surgeon to discuss. Lower lid fat grafting may resorb or may harden.

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 51 reviews

Cheek augmentation with Fat at the same time as Upper and Lower Blepharoplasty

I routinely do this combination of procedures together. This combination is often performed alone or as part of my facelift procedure.  Simultaneously having the lower eyelid fat/muscle issues addressed while performing cheek augmentation is ideal, as the infraorbital V shaped deformity  is corrected.

Your photographs aren't available for review so I can't advise you as to how I would proceed with your case, but the upper/lower blepharoplasty  and fat augmentation is a great combination.

Rondi Kathleen Walker, MD
Washington Facial Plastic Surgeon
4.5 out of 5 stars 16 reviews

Blepharoplasty and fat transfer work well together.


Without pictures it's hard to advise, but here are a few general points:

1) Transconjunctival UPPER blepharoplasty (unlike lower blepharoplasty) does not work well.  It's best to treat the upper lids through the skin.

2) If lower lid fat is re-positioned properly (instead of just being removed), you may not need fat transfer to the lower lids.

3) Fat transfer to the upper cheeks is usually a very good idea.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

It is perfect to combine

It is absolutely perfect to combine these procedures. In my opinion they are great to do together.  As we age, we gain fat in areas we do not want, such as the lower eyelids, and loose fat in areas we need it such as the cheeks. These procedures redistribute the fat to the areas we need.  Hope this helps!

Monica Halem, MD
New York Dermatologic Surgeon
4.4 out of 5 stars 7 reviews

Blepharoplasty and Eyelid/Cheek Transfer

It is not only OK to do a blepharoplasty and eyelid/cheek transfer at the same time, this is the ideal way to have this work done. You have only one operation and recovery. I have successfully done these procedures simultaneously for years.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 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.