Fat Ball Leftover from Eyebag Surgery

Immediately after transconjunctival Blepharoplasty, I noticed a quarter inch round ball bulge beneath 1 eye. Like an after-injection bump. When asked during 1st post-op review how it got missed, doc says probably not missed, likely fat was adjoining a blood vessel stem that would be jeopardised if he got too close. He claimed fats has stems too, like califlower. Do you agree? Says I wouldn't want to risk opening up again. Why not because 9 months post op, it is lookling like fat not removed.

Doctor Answers 6

Blepharoplasty revision

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I do not get it. No one is perfect and any surgeon can miss a small piece of fat. If that occurs just take the patient back and take out the piece of fat left behind and make everyone happy.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon

Sounds like surgeon BS.

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Surgeons have a simple means of dealing with troublesome blood vessels--its called cautery!  Zap, Zap and no more troublesome blood vessel.  When eyelid surgery is done, the transconjunctival lower blepharoplasty is designed to make a very inconspicuous incision.  However, this incision also makes the surgeons visualization of the fat more difficult.  Despite our best efforts, fat can hide out and low and behold persist after surgery.  The best way to deal with this is to simply be honest about it and address it with a small revisional surgery and not confabulate stories and make excuses.  Remember, ultimately this surgeon will be the most motivated of anyone to make you happy.  However, you may be at an impasse with this person and you may need the help of another surgeon if your original surgeon does not undertake the revision.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Revision Blepharoplasty for Eyelid Bags

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Yes the fat has a stalk! However, I would do a revision blepharoplasty to remove the fat. It is not uncommon for blood vessels to sit over the fat and interfere with surgical removal. However, 99 percent of the time, the vessel can be pushed aside to access the fat. Now that you may have internal scarring from your previous surgery, and this could further get in the way of moving the blood vessel out of the way to enable fat access, I would decide, after an evaluation in person, whether to remove the fat bulge through the same transconjunctival blepharoplasty approach vs. performing a standard blepharoplasty through and external incision in order to successfully remove the fat once and for all.

Anita Mandal, MD
Palm Beach Facial Plastic Surgeon


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Any surgeon can leave fat behind.  In fact, when in doubt,  it is better to leave too much fat behind than to remove too much fat.  You can always go back and remove a little more.

However, making up fanciful excuses is not the sign of a confident well trained surgeon. Best wishes. Knowledge is power.  Luis F. Villar MD FACS

Luis Villar, MD, FACS
West Palm Beach Plastic Surgeon
4.4 out of 5 stars 11 reviews

Residual bag in lower lids

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This is probably a residual fat pad missed during the initial surgery.  I have not seen pics so cant tell you for sure, but typically this can be reliably addressed with a simple revision.  If it persists, get another opinion from an eyelid specialist to get the best evaluation.  You can find such a doctor in your areas by searching on asoprs.org.

Best of luck

Dr. Massry

Guy Massry, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 54 reviews

Residual Lower Lid Fat After Blepharoplasty

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There are no "blood vessel stems" to jeopardize during removal of lower lid fat.  It is not uncommon for excess fat to persist after lower blepharoplasty, especially on the outer part of the lower lid.  Excess fat after lower blepharoplasty can be removed during revision surgery.

Michael McCracken, MD
Lone Tree Oculoplastic 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.