Fat Grafting for Hollow Eyes with Thin Skin? And How Much It Would Cost? (photo)

Dear whatsmyname,


    A fat transfer to the eyes would look great on you

    It is a nice permanent and natural looking procedure

    The cost can vary, and expect to have starting prices in the 3K range

    When looking for the right doctor, ask your friends, visit websites, possibly even asking your primary care doctor


Best regards,
Nima Shemirani

Fat and/or filler injection can help fill the upper cheek and lower eyelid hollows. Lower blepharoplasty with fat transposition (meaning the fat bags are moved inferior to fill the hollow dark circles) may be an option if enough fat present. See an oculoplastic surgeon for evaluation.

I agree with the other physicians that you have a significant tear trough deformity.  Fat grafting could help, but this procedure is essentially an injection of a permanent filler, your own fat.  You may want to try injection of a hyaluronic acid such as Juverderm or Restylane to see what improvement you achieve.  Although temporary, this would give you a good idea of what a fat injection could do for you.  Some surgeons believe that the injection of fat improves the skin texture and reduces darker pigmentation as well, but I am not entirely convinced this is true.

A lower lid blepharoplasty, with movement of the fat pockets that surround your eye into the tear trough region would work well.  In this kind of procedure, additional surgical maneuvers such as release of the orbicularis retaining ligmament, tightening of the lower eyelid and a chemical peel to lighten the color of the lower eyelid could also be performed.  Without examining you, I cannot tell which of these procedures will help you, but it is likely you have multiple factors that are causing your problem.  It is unlikely that fat grafting alone will give you the best outcome. 

To find your surgeon, I would seek out a board ceritifed plastic surgeon or a board certified opthalmologist that specialized in cosmetic eye surgery.

Thank you for your questions.

Honestly, your photos are a bit blurred so not ideal for making recommendations, however its seems to me that you have a combination fat prolapse with a tear trough deformity.

An in person consultation can help determine whether a lower blepharoplasty with fat repositioning may be enough for you, or whether fat grafting would also be needed to augment your tear trough and possibly cheek. You should recognize that the tear trough is a challenging location for fat grafting as poor technique can lead to lumpiness and poor contour.

Dr. Denise Garcia is a well trained oculoplastic surgeon in the Scottsdale region in Arizona.

  Facial fat grafting procedures have become very popular in the past few years, because, if done correctly, they can produce a subtle or dramatic result that is permanent.  I think your photoshopped image is not unreasonable, and I think you need to find a plastic surgeon with ELITE credentials to address your needs. 

Since you have not cosmetic procedures before, you may want to consider restylane or belotero first for this area. Consult with three board certified plastic surgeons who are expert and experienced in fat transfer and who are master injectors. The cost for fat transfer like other cosmetic surgery varies considerably across the
country and even in the same area. South Florida tends to have lower fees then
more expensive areas such as New York or Los Angeles. We charge starting at $1000 for fat transfer to the face. Since you can get quality work
at lower costs, patients will travel from throughout the state, the country,
and internationally to have surgery in South Florida.

To ensure that you are receiving quality work with personalized care at the
most cost effective prices, consult with board certified plastic surgeons that
own their own nationally accredited facilities. The quality must be maintained
at the highest level to maintain accreditation. The surgeons also have
incentive to hire and train quality staff (to ensure that surgery is efficient
and enjoyable), to ensure comfortable and private facilities (to encourage
referral), and to eliminate waste (to ensure that these facilities can compete
effectively).

Fat transfer costs between $2500-5000.  For region like the eyes, seek consultation from a fat transfer specialist with experience treating this area. Ask to see before and after photos prior to surgery.

You have a problem that is common to all of us with aging. This can be helped with surgery or with injections

It is very important to preserve (or restore) soft tissue volume in the lower lid. Please view my fat grafting gallery below.  When I review with eyelid surgery patients some photographs from their twenties, in most cases we find that years ago there was no visible demarcation between lid and cheek, but instead a smooth, gently convex curve extending downward from the lower lid margin.

In patients who have developed deep 'tear troughs' at the junction of the lower lid and cheek, adjacent to the side of the nose, the meticulous grafting of fat harvested from the patient's abdomen, hips or thighs can build this area back up and nicely restore a more youthful contour. In some blepharoplasty patients this depression or 'hollow' extends horizontally across the entire junction of the lower lid and cheek, and this must be corrected to obtain the ideal postoperative result.

I think it may be reasonable to share a photoshopped image of yourself in order to convey your desired goals, but you must be realistic with your expectations. Look at the before and after images on this site of lower eyelid rejuvenation and see if you find others with a similar starting pint and a result like you are hoping for.