Can I Use my Own Fat to Fill my Tear Troughs?

Fat grafting is the gold standard.  Better than Juvederm or Restylane because some of it lasts and is not absorbed (I still use Juvederm in the office because it is quick and easy).  Loose skin requires a blepharoplasty and sometimes laser resurfacing.  I frequently perform lower blepharoplasties in combination with fat injection.  The blepharoplasty redrapes the muscle and removes extra skin.  The fat grafting fills in the tear trough.  There are examples on my website.  I attached "Ideal Facelift" but "Ideal Face" is also a good area to visit.

You can use your own fat, but this often times is not the smoothest appearance. Thank you for your question and good luck with everything.

While autologous fat can certainly be used for filling the delicate tear trough area, I would be reluctant to use it. For one thing, retrieving the fat for use in this way is a two procedure method. Fat must be withdrawn under local anesthesia from an an area, such as the thigh, abdomen or buttocks (procedure #1), processed, and then reinjected into the tear troughs (procedure #2).

Since the true  longevity of transplanted fat grafts is still a subject of some dispute, and since often fillers placed in the tear trough area--where there is relatively little movement that can contribute to mechanical breakdown-- fillers injected into that region often maintain correction for well over a year, if not several years. (Anectdotally,  I treated my own tear troughs six years ago as a birthday gift to myself and still do not need any re-treatment).

 I have more than twenty years of experience in treating tear troughs with all kinds of materials, including Zyderm and Evolence.  Because hyaluronic acid fillers, such as Juvederm Ultra XC, can be injected smoothly into this region in microdroplets,  and may be quickly, easily, and completely dissolved afterward with an enzyme, hyaluronidase if so desired, I prefer this to far less forgiving materials, such as fat or permanent fillers, like Artefill. 

Can you use your own fat to fill your tear troughs? Yes.  Without more information or pictures however, I cannot tell you if that's what you need.  I often prefer using a soft tissue filler such as Restylane or Juvederm as the results are more predictable (fat is one of the first "fillers" that surgeons tried- dating back to the turn of the previous century, and we still have not perfected it).  Plus, if you don't like the results, the Restylane or Juvederm will dissolve, whereas fat may not.  If my patients are happy with the filler results, and they want something more permanent, I'll reach for a cheek implant specifically made for that area.  The results are natural, outstanding, long-lasting, and can be removed if ever you don't want it there.  Regarding the loose skin- that also depends on how loose, and what the underlying muscle/fat/skeletal anatomy is like- most often a blepharoplasty is needed, someties just a simple chemical/laser peel will do, or just restoring the volume with filler or implant is enough to reduce the skin laxity.

There will be a variety of opinions as to the best option for tear trough correction.  

My personal favorites are hyaluronic acid fillers (such as Restylane or Juvederm)  or fat transposition blepharoplasty.

With hyaluronic acid fillers, the main downside is that the result is not permanent.  In fat transposition,  fat from the orbit underneath the eyeball is draped over the bony rim of the orbit into the tear trough.  The improvement tends to be permanent.  Not all patients will have enough orbital fat prolapsing to allow fat transposition to be a great option.  Some surgeons have had great results with transfer of a patient's fat (harvested from another area) into this area  (fat transfer),  but  others have become much less enthusiastic for the technique in the lower lids after facing challenging complications which are difficult to correct.

If you do elect fat transfer for the tear troughs, be sure to choose a surgeon with a great deal of experience with using the technique for this particular purpose.

Good luck!
 

Mark Lucarelli, MD, FACS

Madison, WI

In my practice, lower eyelid grooves (tear troughs) are managed with Injectable Fillers. My personal preference is to use Silikon-1000, an off-label filler for permanent results. You should make sure your physician is skilled in the delicate art of filling lower eyelid skin as this area is not forgiving.

Lower eyelid wrinkles are a difficult problem, and a pinch-blepharoplasty is considered as a last resort in select patients.

I hope this is helpful for you.

Certainly, fat grafting is a very effective treatment option for the hollowness under the eyes, a.k.a. "tear troughs". Rarely, I use fat grafting for this area alone but rather as one important component in global facial fat grafting (we loose volume throughout the face as early as in our late 20s/ early 30s). Alternatively, in patients who are also bothered by under-eye bulging fat, lower blepharoplasty with repositioning of the bulging fat into the tear-trough hollows is an effective procedure.

If you are considering non-invasive treatments, hyaluronic acid fillers can be used very effectively for tear trough enhancement.

Sure, as you can tell, many surgeons are anxious to graft fat into your lower eyelid.  The reality is that this is a very unsuitable area for fat grafting.  Grafted fat does best when it can be hidden in existing fat.  It is good in the cheeks, chin, lower face, temple, but no in the lower eyelid.  The lower eyelid is very thin.  Any issue like a lump or bump will show as the swelling settles.  This leaves a permanent irregularity visible in the lower eyelid.  Removing these irregularities is not straight forward.  At a minimum this requires another surgery.  Fat grating itself requires a surgery.   Fat grafting scars the eyelid and midface in unpredictable ways.  For many, many individuals Restylane filler is a much better option.  It is hyaluronic acid filler not fat grafting that is the gold standard for filling the face.

Yes, fat grafting can definitely be done to treat the tear troughs. Fat grafting is very technique sensitiv and not all surgeons are comfortable (or experienced) in the technique.

I have had good success in treating the tear trough area without running into problems with lumps or overfill. The key point is placing the fat in proper volumes (not too much fat at a time) and in very small aliquots (I place the fat using multiple passes with only a small amount of fat placed per pass).

Yes you can, please see below.Facial fat transfer, also known as facial fat grafting or lipoinjection, is a cosmetic procedure that involves injecting fat into the face to restore volume and improve the appearance of the skin: How it worksFat is extracted from another part of the body, usually the abdomen, thighs, or buttocks, using liposuction. The fat is then purified and injected into areas of the face that need volume, such as the cheeks, under the eyes, or around the lips. BenefitsFacial fat transfer can help to: Fill in sunken cheeks and the eye area Reduce the appearance of line folds and scars Enhance lip size Improve overall skin quality AlternativesFacial fat transfer can be an alternative to a more invasive facelift. It can also be combined with other treatments, such as dermal fillers or Botox, to create a more sculpted look. RecoveryAfter the procedure, patients can expect 7–10 days of swelling and some mild bruising. PermanenceWhile facial fat transfer is considered a permanent intervention, only about 60% of the injected fat is retained.