If Too Much Fat Was Removed During a Blepharoplasty, Will It Get Better over Time or Worse? I'm Two Years Post Op.

Question

At about 1.5 years post eye surgery my eyes just looked startling. Not like my eyes at all, very hollow, bony and old. So, I guess up until that time, I had just enough swelling that my eyes looked pretty good. Now they look horrible. It seems whenever I work out and sweat a lot, the worse they look. So, I'm thinking if I lose weight or as time goes on, the loss of too much fat around my eyes is only going to get worse. Am I correct?

A.J. Amadi, MD · Answer

Unfortunately volume loss does occur with age. It may be, however, that we may be able to address that with techniques that replace fat within the eye socket, or surrounding structures. Fillers such as Restylane and Juvederm may also be useful.

	If you post your photos, we may be able to give more specific recommendations.

Mehryar (Ray) Taban, MD, FACS · Answer

The hollowness around the eyes get worse with aging. The hollowness can be compounded if aggressive blepharoplasty with fat removal is done. However, there are treatment options available, namely filler or fat injection. Consult an oculoplastic specialist.

Toby Mayer, MD · Answer

Hollow eyelids after blepharoplasty will become worse with time. We all loose fat with aging. It can be improved by CONSERVATIVE filling but not with fat except if done with a revision blepharoplasty.

David Shafer, MD, FACS · Answer

Yes, if you have hollowness from someone taking out too much fat, then you may be a good candidate for filler treatment or fat grafting to replace the missing volume.

	 

	Good Luck.

Brent Moelleken, MD · Answer

There are two primary reasons that hollowness occurs after blepharoplasty.  First, existing hollowness is unmasked when excess skin is removed.  Second, fat is removed from the upper eyelids.

	Modern techniques can indeed achieve volume replacement or redistribution.

	Since your surgery was over two years ago, it is likely that you are observing the final result.  If the eyes appear too hollow, it is often possible to replace the missing fat with grafts of various types.  We prefer autologous fat-fascial grafts for this purpose.

	There was an era when fat was aggressively resected.  This era is also noted for aggressive removal of under eye skin and a change in shape of the lower eyelid.  Often it is advisable to address this problem at the same time.  If the problem is not severe, improvement can usually be expected with a cheek lift procedure.

Jonathan Kulbersh, MD · Answer

I am sorry to hear you are not satisfied with your blepharoplasty.  Current techniques in blepharoplasty stress the preservation or even the addition of volume around the eye to prevent a hollowed or skeletonize appearance years after the surgery..  As you age, the volume around your eye may slightly decrease or stay the same.  I would anticipate that you the appearance of your eyes will stay the same for a while, and you may begin to lose more volume a down the road.  Nobody can know if you will lose volume or how much.  

	 

	There are procedures that can be done both surgically and non-surgically to improve your condition if you become interested.

	 

	I hope this helps.

Michael Law, MD · Answer

I often correct over-aggressive blepharoplasty procedures performed by other physicians. Fat grafting can often work wonders for hollows in the under eye area and the hollow area in the upper lid , brow junction.  You wan to be careful to find the right plastic surgeon for you the next time around. Look for an experienced fat grafting surgeon with many photos to share.Your surgeon will likely want to view many photos of you from multiple angles before surgery, so start putting these photos together.

Peter E. Johnson, MD · Answer

Over removal of orbital fat is a problem, and you can look washed out and hollow as you age. The bit of good news however is that orbital fat is 'privileged' in that it is the last to be lost until you dwindle to nothing as far as weight loss is concerned. Filler and fat transfers with caution can help in the meantime.

Amiya Prasad, MD - Account Suspended · Answer

The changes with your eyes after surgery can be related to several factors. Looking startled, "bony" or "hollow" have several anatomic aspects which may be correctable. At this point, since surgery related swelling has resolved, it may be worthwhile for you to meet with the original surgeon and/or get additional opinions regarding revision procedures or nonsurgical enhancement of your appearance ( for example placement of fillers such as Restylane in the tear trough and under eye area).

Robert Shumway, MD - Account Suspended · Answer

There are many options available for orbital rejuvenation including placing fat back into the region, if appropriate.

If Too Much Fat Was Removed During a Blepharoplasty, Will It Get Better over Time or Worse? I'm Two Years Post Op.

Answers (10)

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