Is Fat Redraping Same As Fat Repositioning to Address Eye Hollowness and Bags? (photo)

What I see in your posted photos is a visible tear trough especially on the right, a very slight fat bulge on the right and slight muscle bulges just under the eyelashes more so on the right in the no smile. In the smile the fat bulges become more prominent as do the muscle bulges especially on the right. In my experience fat removal through incisions inside or outside the eyelid will create a hollowed out skeleton appearance. Redraping or repositioning the fat over the bone rim under the eye when the before surgery fat bulges go in and out like yours in my experience does not work. Your best bet is therefore a filler inject under the fat bulges. However that will not do anything for the muscle bulges that are very visible in the smile photos.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

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.

There are many ways to achieve the desired result here, and different surgeons may offer different approaches based on their comfort level and experience. Both injectible fillers [Resylane and Juviderm] as well as fat transfer can be used to address you problem. With fillers alone, it is a bit more challenging to achieve the ideal result and may need a few syringes for both sides.

One technique that has yielded excellent results, is a combination of conservative fat excision, with fat transfer to the hollows just below the lids [tear trough]

Best of luck

Fat redraping (or lower lid fat transposition) should not alter the lower eyelid position if done correctly, and it is a good option for you.  As you suggested, filler injection is another option.  Consult an oculoplastic surgeon.

Dear Essence 1981

Thank you for your question!  The shaping around the lower eyelids is very important- just as important as the eyelid surgery... adding the volume under the eye eliminates the hollow and provides support for the lower eyelid- preventing the increase in white show.  With the surgical approach Fat Grafting gives great results. Non surgically you have Restylane placed on the deep layer to correct the hollow.

 

With Warm Regards,

Trevor M Born MD

The short answer is yes; from your photos, I do not see any skin excess, and a very small amount of fat in the lower eyelids.  I treat this quite a bit with fillers alone with excellent results.  You can choose a dermal filler like Restylane or Juvederm, or you can use your own fat- which can give excellent permanent results. I agree that you need it transferred to the orbital cheek junction. I dont think you need fat removal, as I believe this will make your eyelid look too hollow.  Repositioning is an option, but I believe that you need more fat fill than what the repositioning will give.  If you choose to have the lower eyelid surgery, then I agree that you should certainly do the transconjunctival approach for the reasons already mentioned.  In summary, you have choices, and each Plastic Surgeon will have their preferences on how to treat.  Good luck!