Is it advised to do lower blepharoplasty without fat repositioning?

First , it’s important to realize that the lower lid lengthens with age, and should be treated according to the issues seen.  I personally do lower lids three different ways; it truly depends on patients desires and what I see on exam.  I used fat repositioning in approximately 40 percent.  I perform a SOOF lift 30 percent and 40 percent careful fat removal without repositioning.  They almost always include either resurfacing or skin pinch. 

Although excising fat during a lower blepharoplasty is sometimes needed, most cases of lower eyelid fat prolapse are best addressed with a fat preserving technique. This involves repositioning the excess fat into the tear trough hollow below. This does increase the time and complexity of the case, but usually delivers the results that can last a lifetime. Experience Oculofacial plastic surgeons almost exclusively use this technique to avoid over hollowed eyelids. 

It depends very much on your anatomy. If the primary issue is a tear trough groove that's visible, I prefer fat repositioning. If you are young, suffer from allergies and have mainly a fat bulge, usually it will be removal of fat. I sometimes use fat grafting if there is not much fat but you have significant exposure of the tear trough groove.

Fat repositioning should be done to avoid sunken hollow eyes after lower blepharoplasty. If only eye fat is removed, then hollow sunken eyes can happen. Preserving the eye fat bags and repositioning will avoid that problem.

Hi Momo,Fat repositioning, to clarify, is essentially loosening up the lower eyelid fat (which causes the puffiness of the lower eyelids) and suturing it down onto the cheek bone so that it heals in that position.This technique is not always done with lower blepharoplasty, but the surgeon will sometimes do this during the lower blepharoplasty in order to fill in the area between the lower eyelid and the cheek-- the depression known as the 'tear trough.'Bottom line: it depends on your anatomy.  If you have a prominent tear trough, your surgeon may consider this technique during your lower blepharoplasty, or may recommend fat transfer or fillers.Best wishes,Dr. Jay