Drooping After Fat Grafting on Hollow Upper Eyelid

Question

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.

Brent Moelleken, MD · Answer

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.

Otto Joseph Placik, MD · Answer

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.

Steven Wallach, MD · Answer

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

Robert M. Freund, MD · Answer

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.

Pat Pazmino, MD, FACS · Answer

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.

Drooping After Fat Grafting on Hollow Upper Eyelid

Answers (6)