Hollow eyes after lower transnconjunctive blephorplasty - what can I do to fix this? (photos)

Question

I had a lower blepharoplasty to remove some herniated fat. It left me with very bad under eye hollows. Is there anything I can do to fix this?

A.J. Amadi, MD · Answer

Based on your photo, it is difficult to address your volume needs since you are smiling, but options include fat transfer (fat grafting), fillers, or possibly a tear trough implant.
Virtual consultations on are available.

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment on the outcome of a procedure we need to proper before and after pictures. If you don’t have those than ask your surgeon to forward the ones they took. Plastic surgery before and after pictures should be taken without facial expression. We also need to know how long ago your surgery was and if you had any other eyelid procedures.
Restoring the lower eyelid fat pads is not really possible. Grafting fat in that space is not a realistic option. The fat pads removed sit behind the Peri orbital septum. A mid facelift which is a procedure not commonly done anymore may be a very real option for you though there are not a lot of plastic surgeons who do the procedure anymore. A mid facelift is aimed at restoring mid face volume and it’s completely different than the traditional facelift.
Whatever procedure you consider it needs to be done by someone who is mastered Peri-orbital plastic surgery. It doesn’t matter if the person is trained ocular plastic surgery, facial plastic surgery or plastic surgery. You need someone with years of experience and a proven track record.
Proper vetting of providers may have prevented you from being in the situation you’re in now.
Restoring volume in this area is difficult and long-term permanent solutions are limited.
Facial skeletal structure and soft tissues need to both be assessed and see where improvements can be made.
Finding the right provider is always the key to quality results.
The process should always involve thorough in person consultations.
For primary procedures patients should ask providers to open up their portfolio and share their entire collection of before and after pictures.
For revision work that becomes more difficult because every case is different and plastic surgeons typically do far less revisions especially on other doctors patients than they do primary work.
Still, the surgeons who do the best revision work often also do the best primary work.
Some very talented plastic surgeons may also be apprehensive of taking on other providers undesirable outcomes.
Recognize the taking on a patient who has been left with a less than outcome by somebody else can be a thankless job and sometimes restoring someone to what they had hoped to look like may not be possible. often the surgeon taking on these patients and up owning all the problems created by somebody else.
Doing revision work can end up consuming hours of valuable time for the surgeon on patients who in the end are often gun shy and end up not having surgery.
You’ll simply need to start the process one consultation at a time.
Avoid simplistic answers like posting on real self.
It simply is impossible to give you a quality assessment and at this point you need to quality everything.
Make a list of senior plastic surgeons in your community who seem to have a stellar reputation and consult with them one at a time making careful notes of what each has to say and what you learned from each consultation.
For a second opinion consultations patients should come prepared bringing with them at all before and after pictures and a copy of your previous operative report. These are all available from your surgeons office as they are part of your medical record.
Best,
Mats Hagstrom MD

Hollow eyes after lower transnconjunctive blephorplasty - what can I do to fix this? (photos)

Answers (2)

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