Hollow Eyes? Had Orbital Rim Implants and Fat Transfer and Unhappy With Results?

Hey. I am a 22 years old young woman. I have been plagued by a long time my eyes. They are tired and big. I have been in the house of the health section, which set the orbital rim implants under the eye.The surgery was performed last October. In addition, I had fat transfer last week. However, the end result is not what i want. I would like to ask the opinion of other surgeons. Is there any surgery to fix this? Can i send photos on e-mail?

Doctor Answers 6

Lower Eyelid Hollows


You can post photos to this website or send emails to my office.  What brand/style/size of implants did you have?  How much fat transfer?  Really you need an exam to say for sure, but the implants could be too small or too low.  The fat transfer may have dissolved as it often does.

Austin Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

Photos please

Generally, we have have stopped using orbital rim implants except for severe reconstructive cases of bony abnormalities. Fat grafting and fillers are the mainstays of our treatment.

Obviously, we would need to see your pre and post op photos to assess your situation.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Hollowing around the eyes

Loss of volume or hollowing of the upper and lower eyelid regions can be improved with either fat grafting or Hyaluronic acids. Its not uncommon to perform a series of these treatments to achieve optimal results.

Craig Mezrow, MS, MD, FACS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 17 reviews

Generally fixable.

Unfortunately it is not always possible to unstir the cream out of the coffee.  It is my opinion, and I have pioneered one of the mid face/orbital rim implant surgeries, that this is not a cosmetic surgery. The fillers have gotten so good that for most individuals it is hard to justify the risks that are involved with the orbital rim implants.  The risk I am thinking of is deep personal disappointment with the aesthetic results which is often not well understood by the surgeon who performed the original surgery.  There are individuals for whom my ePTFE orbital rim implant surgery with a vertical midface lift is appropriate but they have generally had a prior disappointing surgical result in the lower eyelid/midface area.

In sending photos, it is a good idea to first make contact with a surgeon's office to determine that this is an area they can help you with.

Understand that this is a highly specialized situation and you need to find the true experts in the field to help you.  Proceed with caution.

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

Hollow lower lids

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.

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 48 reviews

Unhappy with orbital rim implants and fat transfer

I agree with several of the other posts. I prefer hyaluronic acid fillers in the tear trough over fat transfer or orbital rim implants.

That being said, if you are still hollow after the other procedures, it may be able to use Restylane to add additional volume or camouflage the areas you dont like. I also like using Restylane to camouflage uneven or lumpy areas after fat transfer.

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 165 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.