Will having the fat pads removed from under my eye cause hollowing over time?

Question

I am 21 and and concerned that if I have lower eye lids surgery I will develop hollowing because I had it done at a hound age.

Mehryar (Ray) Taban, MD, FACS · Answer

Do not take fat out! Yes you will get hollow sunken under eyes if you remove the fat bags. It is best to reposition/redistribue the fat bags. See following link and video. It is called transconjunctival lower blepharoplasty with fat repositioning.

John J. Martin, Jr., MD · Answer

If done conservatively transconjunctival fat removal should be fine.  If too much fat is removed, you can end up looking hollow and will then need either fat transfer or filler.  An option that helps to prevent this post-op hollowing is to reposition the fat.  This is also done from inside the eyelid.

Alan B. Brackup, MD, FACS · Answer

Your photo is taken at an odd angle, and you're smiling, so it's difficult to see exactly what would work best for you.  From your photo, you appear to have fat prominence on your right side alone, so perhaps surgery on that side is all that's needed.  A transconjunctival approach through the inside of the eyelid would be the safest.For many individuals, especially those who have fat projecting at a young age, fat removal in blepharoplasty is both appropriate and necessary.  I

John Paul Tutela, MD · Answer

Thanks so much for your question. If the fat you remove from your eye is not over done it should not look hollowed out. However there is always a chance but if two much is resected that you may be hollowed out.   Be sure to be see a board-certified plastic surgeon in order to get the correct diagnosis and plan.

Vincent N. Zubowicz, MD · Answer

The modest surplus of fat which appears in the lower lids would best be transferred to the tear trough area. This makes good use of this valuable tissue and will prevent the hollowed out look you are trying to avoid.

Reza Momeni, MD, FACS · Answer

If the fat pad removal is very aggressive, it's possible as you have pointed out to get hollowed lower eyelids over time as one ages.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search.

John S. Alspaugh, MD, FACS · Answer

I prefer to transfer the fat to the area below the bags which is often sunken. This produces a more youthful effect

Sean Freeman, MD · Answer

jw35, the average patient does not need fat removed from the lower lids during blepharoplasty. the exception is in patients with congenital pseudo-herniation; these patients have early onset of puffy lower lids that runs in their family, typically in their teens. In these patients fat removal is actually indicated. See an experienced plastic surgeon that specializes in "only faces" or in oculoplastics. See the video and good luck!

Steven Wallach, MD · Answer

If you have lower eyelid fat, then this can be removed conservatively through a transconjunctival incision which is placed inside the lower eyelid ( no external incision)

Michael Carlisle, MD - Account Suspended · Answer

You can have very minimal fat removal through an inside the lid incision. No external incision. This fat for you would then be re-drapped over that little hollow line from the corner of your eye that goes underneath. This will decrease the puffiness above the line and get rid of most of the line. Best of luck!

Will having the fat pads removed from under my eye cause hollowing over time?

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