Is Fat Repositioning During Lower Blepharoplasty a Common Procedure?

In most patients with changes of aging around the cheeks, the cheek has dropped considerably.

We've found it is usually best to elevate the cheek via a cheek lift and reposition the fat rather than just reposition the fat.  Then, the cheek with its fatty tissues is positioned higher and can hide lower eyelid hollowness.

Fat repositioning is not a common practice by any means, and still quite controversial, particularly procedures which involve division of the orbital septum or tightening of the septum.

It's best to select a surgeon with an interest in the mid face / cheek lifts.

I really believe that fat repositioning is a mistake and accomplished absolutely nothing.  I remove the fat and get excellent results.  Some say that will lead to a hollow look.  However I have done thousands of lower lid blepharoplasty and have yet to have this problem. Also remove the term negative vector from your vocabulary.  It’s more fancy word play that has no practical use.  Just get a standard bleoharoplasty.

Hi! Thank you for your question,


I am Dr. Speron, a proud member of both the American Society of Plastic Surgeons (ASPS) and the American Society of Aesthetic Plastic Surgeons (ASAPS).  I am also certified with the American Board of Plastic Surgery.


Fat repositioning is an ideal method of lower blepharoplasty rather than fillers since it corrects puffy bags below your eyes and fills up the hollow dark circles. It gives more of a youthful and natural look. I highly recommend you schedule an appointment with your board certified plastic surgeon to see if you are a candidate for the procedure.


Below are some links for additional information and before and after pictures.


If you have any further questions, please feel free to call us at 847.696.9900.


Best of luck and have a great day!


Regards,


Dr. Speron

I do this procedure of fat repositioning with a blepharoplasty commonly in my practice. If the patient is getting sufficient elevation with a cheek lift then it is not necessary. Otherwise this is a common procedure using the fat from the mountain to fill in the valley with a blepharoplasty.

Lower blepharoplasty with fat transposition (or repositioning) is an excellent effective procedure to accomplish two goals:  1) reduce the bags/fat of the lower eyelid;  2) to fill up the hollow dark circles.  Done correctly, it is very safe and effective.  See an oculoplastic surgeon familiar with the procedure.

Fat repositioning is very effective for the properly selected patient. Some or all of the lower eyelid bag is repositioned into a position that fills the undereye hollow. It can create very nice results for both the lower eyelid and undereye hollow. Someone who recommends removing excess fat and then replacing volume with yearly filler treatments is, unfortunately, not doing you any favors. You might consider seeking a second (or third) opinion if that's the advice you're receiving. I hope this information is helpful.Stephen Weber MD, FACSWeber Facial Plastic Surgery

In the past 10 years, fat repositioning has become more and more common as we've recognized the importance of preserving eyelid volume.

In the younger population, this is my procedure of choice, since the amount of fat prolapse is mild to moderate.

In patients with significant fat prolapse, it is not always possible to achieve a smooth contour when repositioning fat, so excising some fat may be required.

I use both fat repositioning AND/OR fat excision with fat grafting in my practice. Each patient deserves an individualized surgical plan.  A "cookie cutter" approach to surgery is the sign of a limited surgeon. Seek one that is comfortable and experienced in all the different techniques.

Thank you for the great question. Many plastic surgeons will remove the fat pockets from the lower eyelid region during an eyelid lift.  Some will then add fat to the area by using fat grafts taken from the abdomen.  I think this is the procedure that you heard has a relatively low success rate -- and the reason is that fat grafts from the abdomen don't have an attached blood supply, and a lot of the fat doesn't survive.  A better operation, in my opinion, is a fat transposition lower eyelid lift.  During this procedure, I use the fat that is around the eye to fill in the hollow area between the eyelid and the cheek.  This graft always survives because it remains attached to its blood supply.  This technique can be performed with a skin incision, if there is excess skin that needs to be removed, or without a skin incision (transconjunctival, from the inside of the eyelid) if no extra skin is present.  Best of luck moving forward!

Fat repositioning is an excellent and very valuable tool.  It is very common.  In the right patient, it can produce excellent results. Make sure you are seeing a board certified plastic surgeon in your area. 

 

Best,

Fat repositioning is a valuable tool used to treat lower eyelid bags and give a more youthful appearance.  The results are long lasting and helps avoid a hollowed out appearance to the eyes.  Consultation with a surgeon experienced in fat repositioning will help you decide if this is an option for you.