Lack of orbital fat after blepharoplasty. What about tear trough surgery w/ solid fat, and how to find a doctor for it? (photos)

Sorry you are experiencing this complication of subtractive surgery. In my experience most patients are content with this result as they don't see the bags anymore. However I agree with you that it is not the optimal result as things look relatively hollow. For this reason my go to for lower lid appearances like yours are to do transconjunctival fat repositioning (instead of excision) combined with free fat grafting. By solid fat I presume you are referring to a dermis-fat type graft. I do not perform these in aesthetic cases, mostly in corrective/reconstructive cases. In your case, I would find someone with a lot of peri-ocular fat grafting experience and do conservative amounts of grafting, possibly in series if needed but I would allow at least 1-2 years to pass before doing another round as the results are often delayed. Wish you the best.

I’m not sure what your concern is.
I think your assault is actually quite good.
Your surgeon removed the bulging lower eyelid, fat pads, and the rest of your face is more or less the same.
If you want to restore volume in your midface, you can do so, using fillers, implants, fat grafting, or a midface lift.
I think most people would say you look better in your after picture than your before picture.
I see nothing that was done poorly or incorrectly.
I’m not sure what you are referring to when you say solid, fat or liquid fat.
If you were unhappy with the outcome of the first procedure, then maybe you should hold off on having more cosmetic surgery.
Best,
Mats Hagstrom, MD