Is only a fat removal enough to help me (transconjuctival lower blepharoplasty)? (Photo)

Your tear trough is quite prominent. You would be better off with fat transposition. I do not believe fat removal by itself will solve the problem.

Best Wishes,

Gary Horndeski, M.D.

First, no one should prescribe surgery on the basis of a photograph. These photographs are further degraded because you have obscured your eyes making evaluating your issues in the forum even more challenging. A true physical examination is needed to determine the basis for your under eye issue. You can do your own examination. Put your finder on top of your "bag." What you will be feeling is not fat. I suspect what you will be feeling will be your orbital rim. Your potential surgeon is unlikely to find enough fat to transpose and cover this bone. Why are they proposing surgery then? Sometimes if you are a hammer, the world looks like a nail. I strongly advise you to avoid grafted fat in these area. I see many patients every week who are consulting me after being ruined by grafted fat performed by well meaning surgeons. I suspect your best option is hyaluronic acid filler in the form of Restylane. I am not going to kid you. This is a fussy service and finding the right injector can be difficult.

In our practice, we do not recommend fat injections in the lower lids for a variety of reasons. When there's fat bags present in the lower lids, trans- conjunctival approach with fat removal is the best solution. We do not perform fat reposition on the lower lids.