I have a sunken eyes with a shortage of upper eyelid fat. It's genetic and that's what gives me a tired and elderly look. What is the best treatment for this? A fat grafting surgery? Or a fat injection? Pease help. I'm a 28 year old (female) and my problem isn't the extra upper eyelid fat as most people had but the opposite, a shortage of an upper eyelid fat.
Treatment for Sunken and Hollow Eyes?
Doctor Answers 46
Fat Grafting for the Upper Eyelid Filling Hollow Eyelids with Fat Grafting, Fat Transfer
The upper eyelid is a thin structure that normally does not contain any significant amount of subcutaneous fat. So fat grafting of the upper eyelid itself would not produce an aesthetically pleasing result, and would in fact be quite dangerous to attempt. The area between the brow and the upper eyelid crease, on the other hand, is full of subcutaneous fat in most young people, and that fullness looks youthful. I refer to this area as the ‘brow-upper lid junction’, and I add fat to make it fuller in the majority of patients for who I perform eye-area rejuvenation surgery.
Take a look at the eyes of fashion models in advertisements: in most cases you actually see little to none of the upper lid. What you see is a youthful soft tissue fullness that extends from the brow to the upper lid lashes. As we age, this fatty fullness atrophies and the brow-upper lid junction gradually becomes hollow. The outline of the bony structures below the brow (the superior orbital rim) becomes visible, and one begins to look older, sometimes even ill, and in advanced stages even skeletal. In some patients that I treat this appearance is inherited and they have a hollow look at their brow-upper lid junction at a young age. It is also an appearance that some people have following an overly aggressive upper blepharoplasty, where the surgeon inappropriately removes fat from the brow-upper lid junction.
Unfortunately, this is a result that quite a few patients get from upper blepharoplasty, and I treat a significant number of these patients who need that fatty fullness restored between their brow and upper lid. Whether hollowness at the brow-upper lid junction is something that was always present, something that has developed with aging, or something that resulted from an overly-aggressive upper blepharoplasty, fat grafting of the brow-upper lid junction can rejuvenate the eye area in a manner that is simply impossible by means of standard blepharoplasty techniques. It does not look like ‘surgery’, and patients for whom I perform this procedure return to say that their friends and acquaintances think they look great, but they can’t quite put their finger on why.
A word of caution: this is a delicate surgery that requires a significant amount of experience with fat grafting, careful preoperative evaluation, and meticulous surgical technique. In experienced hands a youthful and aesthetically ideal brow-upper lid contour can be achieved. Make sure your surgeon can show you numerous photographic examples of brow-upper lid junction fat grafting. .
Open fat grafting is the best correction for hollow eyes
I am sure many doctors will suggest fat injection or filler injection to correct your hollow eyes.
I strongly urge you not to have injections done into your upper eyelid. There are many very delicate structures in the upper eyelid which can be injured by a needle used for injection, and injury to the levator muscle could give you a droopy eyelid.
The safest and most effective method to plump a hollow upper eyelid, in my opinion, is an open composit fat graft.
During this procedure, I harvest a small amount of fat from around your "belly button" , make a small laser incision in the upper eyelid, and graft the fat directly into the hollow area of your upper eyelid.
This procedure works very well, has been done for many years, and will give you the best result.
Again, avoid injections in this area-it sounds so easy and simple, but the risks are not worth the possible benefit, in my opinion.
Fat on upper lids is not a great idea!
Although I have vast experience with fat transfer in the lower lids, I am not a fan of fat injections in the upper lids for your problems. The fat may make you lumpy and most importantly the excess weight can affect the muscle from working naturally. Although plastic surgeons love to provide answers for all problems, this may be a case of leaving well enough alone.
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Fat Grafting is likely the best option for you. The synthetic products are also a possibility, however, I feel you will get the most natural result with your own fat. Just make sure you go to someone with extensive experience with fat grafting. Good luck
Fat grafting is excellent for sunken eyes
This is one of the areas that fat grafting really shines. Fat harvested from another part of your body and then reinjected along the upper orbital rim can have very dramatic results. It is usually permanent and has a very high satisfaction rate. If you're not sure, try some Restylane first, it's temporary and reversible.
Eyelids and more
This is difficult to answer with out any photos or a physical exam but yes, we can transfer fat to the upper orbital rim. This is not so much the upper lid as it is the orbital rim/brow junction that makes the largest difference. The actual lid skin of the upper and lower lids is too thin to accept fat without significant issues.
Laser treatments may also be an option depending on your exact issue. You are young so be careful with any aggressive treatments because these can all have side effects.
You are doing to right thing, research many topics and see what you feel will give you the best results.
Hope this helps,
Best of luck,
Fat or Fiction?
Most middle aged patients undergoing facelift surgery have some extra deposits of fat in the lower abdomen or hip areas that are useful sites to obtain fat for re-injection. The fat is harvested by gentle liposuction using a small instrument introduced through a puncture in the skin. The fat is processed and immediately re-injected into the face in micro-droplets that will survive without moving out of position.
Clinical observations have shown that the facial skin overlying the fat injection sites can slowly improve in appearance, texture and sometimes pore size. This secondary benefit is thought to be due to the presence of adult stem cells that reside with the fat that is injected. More lab studies are ongoing to prove this theory.
A Lot Can Be Accomplished With Fat
The key is to be conservative with it and use very small amounts of fat "sprayed" along the border of the bone and also using a bit more fat to support the tail of the brow and give a highlight to the sub brow skin. This can actually lift the brow as well as fill the hollow orbit. My preference is to use fat, although fillers placed with blunt cannulas can also be effective.
Treatment for sunken or hollow eyes
Fat transfer around the eyes.
That said, the procedure has many limitations and is not always predictable.
In general, facial fat transfer works best to give an overall volume enhancement in areas that have a substantial base of tissue in which to graft.
The areas around the eyes can be thin and have the potential of leaving irregular contours, lumpiness and other undesirable results when treated with fat grafting.
That is not to say the procedure is inappropriate.
It is a technique that requires diligence, experience and careful patient selection.
I suggest you consult with an experienced, board-certified plastic surgeon to find out your options.
Best of luck,
Mats Hagstrom, M.D.
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.