How do I get back the periorbital fullness I lost via weight loss and how much does it cost? (photos)

Thank you for your question. You are correct, the fullness of the upper eyelid is a significant sign of youth. The only permanent way to replace this volume is through fat grafting. Cost will vary depending on geography and surgeon. But fat grafting in this area can be very tricky like you said so make sure you are choosing a qualified board certified plastic surgeon when you go for a consultation.Best of luck!

Fat grafting around the eyes can provide a beautiful, natural and smooth appearance. Fat grafting on any area of the face, particularly the eyes requires considerable expertise. It is important to view many, many before and after photos to see examples of the expertise and experience of a plastic surgeon. It is also important to view photos soon after surgery, several months out and a year or more after surgery to determine the longevity of the fat grafting. 

Peri- orbital volume loss is definitely a process of aging and/or over- resection of peri- orbital fat during eyelid surgery.  More plastic surgeons are giving this issue due attention now more than ever before as we have closely analyzed what happens to the volume of the face as we age.  That's why you see more and more fat transfers being done along with facelifts to more effectively restore natural youthfulness.  The most common areas I try to restore volume to are the cheeks, nasolabial folds, lips and tear troughs/ peri- orbital regions.  One option to restore this volume is to use tissue fillers (hyaluronic acid based such as Juvederm and Restylane are most popular).  However, tissue fillers last only 6- 12 months and will have to be repeated on a regular basis for as long as you want the effect of the filler.  This can be very expensive especially if you are restoring volume to multiple areas of the face and if you require a lot of volume.  Using your own fat for fat grafting is usually the better option if done properly as it can actually be less expensive per cc volume than tissue fillers especially if you are doing large volume fat transfers to the face (20- 40cc).  It does carry more risks though as you have stated, such as lumpiness, contour irregularity, asymmetry and failure of graft take.  But, in the right hands (of a board certified plastic surgeon with lots of experience and proven results) and if done properly, it can give you many years (and maybe even decades) of enjoyment.  You have to be prepared for the possibility that some of fat may not survive the transfer process (which you will not know until about 2- 3 months after the procedure) and that you may need a touch up procedure to transfer more fat.  Most hyaluronic acid based tissue fillers, though, are guaranteed to go away.  Fat transfers is definitely the one procedure where choosing the right surgeon will be critical to the success.  Ask to see lots of before and after pictures of their results with good follow up.  Best wishes.

Fat grafting would be useful to improve the periorbital area, but  you would need to find a  board certified cosmetic surgeon as the area around the eye is very delicate.Look on the website of The American Society for Aesthetic Plastic Surgery for a surgeon in your area. He will also be able to advise you on the options available to improve the pigmentation.