Should I Go for Marginalis Release or Fat Graft?

I'm 35 female. Had quad. transconjunctavital blep. 4yrs ago. It was unnecessary. I probably only needed bit of filler in my lower lids & upper lid should'nt have been touched. Since then I've been slave to the fillers as I now have more hollowness around the socket of my eyes. I'm never happy with the fillers as they always look a bit unnatural. I'd like more natural/permanent solution. Should I go for Marginalis Release with pinch bleph OR fat graft? pls recommend the best person for the job.

Doctor Answers 5

Fat Grafting is best option for Hollow Eye after Blepharoplasty

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I always do Fat Grafting during a Transconjunctival Lower Blepharoplasty with Arcus Marginalis Release. You need to ask your surgeon if this was done.

A pinch Blepharoplasty will not correct the depression beneath your lower eyelid-most prominent near the nose.

Typically I prefer to do Composite (Whole Piece of Fat) Fat Grafting under direct vision through a transconjunctival incision.

This requires experience especially since you have had a prior Transconjunctival Incision and surgery.

Fat Grafting may be safer in your situation but you will have to rely on the advice of an expert.

Seek out a Board Certified Plastic Surgeon in your area who is an expert at Occuloplastic Surgery and has proven experience in Fat Transfer and Fat Grafting.

Injecting around the eye requires careful fastidious technique by an expert-if not done perfectly wrong placement of the fat can create lumps and eye injury is always a possibility

Fat Grafting in Eyelids

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If you're dissatisfied with the duration of fillers in your eyelids, fat is an excellent alternative. Make sure that your results. I do not think you need a pinch blepharoplasty at this time.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Eye lid surgery

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I belive your eyes are excellent. May be a slight hollowness in the lower lids

 I prefer fat, Micro- fat grafting. is more permanent, But requires an expert in that technique.

Samir Shureih, MD
Baltimore Plastic Surgeon

Lower eyelid blepharoplasty

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I’m a big advocate of volumizing with whatever gets the best results. A pinch and margincal release will do very little for your state. You need volume. Fat grafting, fillers, or other techniques are better options.


Philip Young, MD
Bellevue Facial Plastic Surgeon

Regardless, you should choose someone that has specific expertise in these areas

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I am a big fan of fat grafting.  The two procedures you mentioned do not have to be either-or, but can be complimentary.  I would recommend fat grafting first by a board certified plastic surgeons that has specific experience in this area.  I suspect you will be happy with this.  You can always have a pinch bleph down the road if you feel it will benefit you.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 170 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.