Drooping After Fat Grafting on Hollow Upper Eyelid

I had fat grafting for hollow upper eyelid area in one eye, in July 2008. I know that some droopiness is expected following such procedure, but can it be more pronounced in one side of the eye (inner in my case), where more fat was grafted due to the nature of my problem? Should I give it more time before evaluating for final result? Thank you in advance.

Doctor Answers 6

Fat Grafting, occassional touch ups can help

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Structural fat grafting is a procdure , in which small amounts (less than 0.1 cc at a time) of fat are carefully microinjected in a series of discrete layers to gradually 'build' new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist. If this process of blood vessel ingrowth (neovascularization) does not occur, then the injected tissue cannot truly be considered a 'graft' and is instead just another 'soft tissue filler' of limited duration.

Fat Grafting requires specialized training and specialized surgical instruments, as well as patience and attention to detail on the part of the surgeon. When performed properly, permanent improvements in facial plastic surgery are possible. If enough fat resorption occurs following a fat grafting procedure such that the desired result is not achieved, a second 'touch-up' procedure can easily be done. Fat grafting has changed the results of facial plastic surgery dramatically. Traditional facelifts simply do not provide the natural result of microfat grafting.

Structural fat grafting can be performed on eyelid hollows, to fill sunken cheeks, for filling sunken hollows under eyes eyes and is often used for blepharoplasty correction when too much skin and or fat has been removed in an eyelid surgical procedure. Some people who have experienced fat loss as a result of procedures such as IPL or Thermage can also benefit greatly from permanent fat injections.

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

Upper eyelid fat grafting

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After six months, patients have usually reached their stable plateau and it is time to assess the final results.

You may wish to go back to your original surgeon and get their opinion on what is going on.

No doubt they will assess the upper eyelid opening muscle (levator), preoperative eyelid position, and assess for scar tissue formation, dynamic function of the upper eyelids, brow position, orbital set (how prominent the eyeball is), lower eyelid position, etc.

If an excess of fat has survived on one side, it may be possible to debulk this very carefully, avoiding injury to the levator muscle and its nerve supply.

In our practice, we prefer single nontraumatized fascial fat grafts for the purpose of reducing upper eyelid hollowness. these grafts are placed in a predictable place and could theoretically be modified fairly easily, although this has not been necessary.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Drooping upper eyelid after fat grafting

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The upper eyelid may droop a little bit after fat grafting secondary to swelling. This may take several months to improve.

Fat Grafting to the upper eyelid

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Fat Grafting to the upper eyelid can be a great way to rejuvenate the eye, especially with the hollowed out look some people get. However, injections should always be on or above the orbital rim, not on the eyelid. i am not sure of your issue, but swelling should resolve within 3-6 months after the procedure.

Fat grafting around the eyes

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Fat transfer to the face in the area around the eyes and it is an extremely powerful and effective technique. Because this area is so sensitive to even small changes in volume, it is essential to work with a plastic surgeon is a great deal of experience in fat grafting techniques, blepharoplasty, and facelift procedures. Your plastic surgeon will be able to determine how much fat is necessary to obtain the result you're looking for. Whenever fat is subject to these areas, it is possible that a certain amount may, and create small little bumps. If this has happened to you, work with your plastic surgeon as they may recommend the injection of the medication into this area to help alleviate this unevenness.

Fat graft survival is difficult to predict with accuracy

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Predicting fat graft survival is similar to predicting how many seeds will sprout when planting. In order to get one plant, you typically place 2-3 seeds per site.

Same goes for fat grafting, we oftentimes "plant" 2-3 times the final desired amount anticipating that some will not survive.

Occasionally more survives than we would like and we need to remove this.

At this point, your fat has likely survived, perhaps in excess of the desired amount. Consider discussing this with your surgeon.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.