Can I still do a fat transfer under eyes if filler has migrated and hasn't dissolved yet? (photo)

Question

Hi I had fillers done for my dark circles (hyaluronic acid) in 2019. The product migrated below the dark circle and still hasn't dissolve yet. It might be permanent I don't know. Can I still do a fat transfer under eyes to treat my circles ? Thanks

Jason Emer, MD · Answer

you can reverse the fillers and do fat but I dont see issues in your photos. I think fillers place properly always look better than fat. also, I would suggst fractora, plasma pen, and lasers in office to improve the apperance of the area.

at home peels like cosmelan, enlighten and aerify along with dermarolling (emerageskin roller with anteage MD ampules) should be started now between the lasers.

There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term.  There are many things you can do to treat under eye hollows and dark circles without surgery.  Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture.  I suggest you get a formal consultation to see what is best for you and your goals.  Best, Dr. Emer.

Mats Hagstrom, MD (license on probation) · Answer

My personal experience has been that fillers do not migrate at all and that migration of fillers is the term used by providers who have undesirable outcomes.

Fat transfer as many times more imprecise and unpredictable in this area than fillers. If you were concerned about the outcome of fillers then you should be many times more concerned about the outcome of using the fat.  it is unpredictable and somewhat unforgiving.  The injected fat survives based on the presence of host tissue and the thickness of tissue gradually changes around the lower eyelids. For this reason fat conserve Vive in an unpredictable way leaving lumpy contours. Areas of fat necrosis are often easily seen and felt and can only be removed with open surgery.

I recommend staying with fillers and finding providers who do quality work.

As a reference you can check out the work being done by doctor David Mabrie in San Francisco. He has very impressive before and after pictures of patients getting mid face fillers and that some of the best work I’ve ever seen.
Look for other providers in your area to do work similar to his. Not all providers take and show up before and after pictures of work done with fillers but those who specialize in this procedure often deal with and those of the providers you’re looking for.

I suppose the same is true for fat transfer but the procedure is inherently unpredictable and somewhat imprecise.

Best,

Mats Hagstrom MD

Can I still do a fat transfer under eyes if filler has migrated and hasn't dissolved yet? (photo)

Answers (2)

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