Correction of Hollow Eyes with Fat Grafting? (photo)

I got pretty severe under eye hollows after a sunburn which bothers me a lot since it has aged my face significantly. I have been researching solutions to this problem online and it seems like its 2 real options, either fillers like Restylane and juvederm or fat grafting. Fat rafting sounds to me like a more permanent solution to this problem then keep injecting fillers under eyes every 6 months to a year.

Doctor Answers 7

Fat Grafting Under the Eyes - View Many Photos for Evidence of Expertise from a Plastic Surgeon

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Fat Grafting, when expertly administered by a plastic surgeon with experise and experience can create a beautiful, natural and lasting result. It is important to select a plastic surgeon with meticulous technique who can demonstrate their abilities with doxens of photographs.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Hollows under the eyes

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Dear auting82,

  • If you would like something permanent, fat transfer is the way to go
  • Make sure you go to an experienced injector because it has to be perfect under the eyes
  • If you are not ready for surgery and would like to see what results can look like, you can try restylane, it has amazing results as well and can last about a year

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Undereye hollowness

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You are correct: both fillers and fat transfer can be effective for under eye hollows [tear troughs], and I do both in my practice. However,in general, though fat transfer is a more permanent solution, it is also a bit more technically challenging and more risky [lumpiness that is hard to reverse].

In my practice, the way I decide on which option to use is the following:  If I feel a patient's face in general,  is volume depleted, and that they could use volume elsewhere [cheeks or brow or temple, for example] I would recommend using fat for the eyelid hollows as well.

But if the patient is somewhat younger, and volume is not a problem overall, and they don't need it elsewhere on the face, then  I would suggest fillers first. It is always easy to move on to fat from fillers if you are not happy with the results, or the repeated injections.

You seem to be in this second category and I would recommend fillers as the first option for you.


A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

Correction of Hollow Eyes with Fat Grafting?

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     Both filler and fat grafting are appropriate.  Restylane in that area is a good choice.  I think fat grafting is a good choice as well.  Find a plastic surgeon with ELITE credentials who performs hundreds of fat grafting procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Fat vs filler for eye hollows

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For the tear trough area, fillers (restylane and belotero) are ideal and it is a delicate thin skin area and fat would be too difficult and lumpy. For cheek and brows, fat is great.  Although fillers are temporary, they can last a long time around the eyes, especially after second treatment.

Fat grafting or Juvederm for tear trough deformity

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While both can help the deep tear trough deformity Juvederm is simple and more precise as long as the surgeon is skilled in injection in this area.  Juvederm can last up to two years here as its a place that does not move very much.  With fat grafting you have to over compensate because some of the fat will not take so for many months you will have a very puffy appearance.  I use Juvederm Ultra Plus with Lidocaine using a 30 gauge needle and just lay small droplets in this area.  This lasts a long time and has a high degree of patient satisfaction. 

Fat vs. Filler

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Dear patient. I would suggest that you start with fillers rather than fat. I will try to explain why I feel this way. Restylane is quite safe under the eyes and can last up to a year. Your line under the right eye is also quite superficial and (at least in my hands) Restylane is more appropriate for superficial lines.You can get small lumps and the blue discoloration called Tindel effect but these are rare and can be addressed. You are right that fat transfer can last 2-5 years but has significantly higher risks. Fat needs to be harvested from the abdomen or flanks which is a small procedure by itself. Fat can also become lumpy or absorb at different rates under each eye. At least in my hands fat transfer under the eye requires a few days off work. Using small Coleman cannulas or small gauge NoKor to transfer the fat results in bruising and swelling. About 10% to 50% of the fat is absorbed within a few weeks. The reason for the wide range of absorption has to do with how the fat is prepared. More compact spun fat with PRP lasts much much longer.With fat transfer I usually have to over correct the area by 10-20% to avoid immediate touch ups. My recommendation to patients new to Cosmetic Surgery is to do fillers such Restylane first to see if they like the result and reserve semi-permanent Fillers such as fat for a later time. I hope this was helpful.

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