Having a Hard Time with the Shape of my Eyes, is This Normal After Upper and Lower Eyelid Surgery and Fat Transfer?

It has been 12 days past my surgery for upper and lower lids and fat transfer to my cheeks,nasal area and under eye area. My eyes feel distorted,I look like I have cat eyes and my cheeks feel very tight and swollen. Before the surgery I had round big eyes now they look sunken. I am very sensitive to light and having a hard time focusing. I've been in touch with the PS and he does not seem to be concerned but I am.

Doctor Answers 3

Eye rejuvenation

I would advise that you have the surgeon visually assess your progress, especially should you notice significant asymmetries. Although I perform fat injections I do them sparingly. I know some of my colleagues feel otherwise and that is good for discussion purposes but in the majority of my patients I can achieve improvement in hollowness under the eyes and cheek area using other more predictable methods. One of the drawbacks of fat injections is that one has to over-fill to begin with to account for expected absorption of some of the transplanted fat. That in and of itself is the reason I use this approach sparingly as the percentage that injected fat gets absorbed is different for each patient. I’ve seen patients with little absorption who look over injected for a prolonged period of time; I’ve seen patients who absorb the transplanted fat fairly aggressively (they look fairly good for about a year but after that you can barely tell you did any injections) and I’ve seen patients that get a good result that can last several years. I don’t like doing things that have that much variability. As the originator of the SOOF lift blepharoplasty I can tell you that in my opinion this is the best procedure for improving the hollow look under the eyes that accompanies the aging process. I've been doing nothing but this procedure since I originally published this approach around 1999 in the Archives of Facial Plastic Surgery and have only had one redo to date. For cheek’s I prefer a midface lift should they have adequate midface fat left and if not I prefer a cheek implant. All these techniques work predictably and last many years with little known risks. I know this is water under the bridge for you but may give other patients pause to consider alternatives. Let’s anticipate that you will be in the group that absorbs the right amount of fat and have a good long term result.

Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 48 reviews


You should make sure that your PS sees you in person to assess you.  Having said that, it is very early after your surgery.  It will take several weeks for usual post-op swelling to improve significantly.  It's too early to we worried about the final results just yet.  It will take 6months to a year to see your final results.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

It is probable that the PS has an interest in not seeing your concerns.

In fairness, you are so early from surgery that many issues may seem very exaggerated and these often resolve with time.  However, I am in the business of fixing issues after cosmetic eyelid surgery.  When I speak with patients regarding when they became aware that there was a problem with their eyelid surgery, they often relay that it was within a day of surgery.  In each case, the original surgeon suggested that there was no issue or the issue would resolve and this is often the case.  Part of the problem is that we as doctors often do a poor job of describing what to expect after surgery and also minimize the profound effect of doing this work around the eyes.

It sound like you may also have some eyelid closure issues with dry eye.  I would encourage you to see your ophthalmologist to be assessed for dry eye and if advised, use artificial tears and ointment at bedtime to protect the corneal surface.  If your eye status does not improve or gets worse over the next 6 to 8 weeks, avoid the temptation to have an early fix in the form of a lateral canthal  procedure or "tuck."  This early efforts are often misdirected and further use up very important eyelid resources.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.