Juvederm and Restylane Caused Bags Under My Eyes, Would a Fat Transfer be a Better Alternative?

I have huge bags under my eyes after both Juvederm and Restylane injections. My plastic surgeon suggested I should have fat transfer instead. He is a very respected facial PS, however I fear the same thing might happen with fat and then it will be permanent.I retain water more than most, which he says is causing the fat pads under the product to swell. I take prescription water pills, but this hasn't helped. I still have the hollow eye ridge that prompted me to have the injections in the first place! I am wondering if any of the doctors have experience with a similar situation.

Doctor Answers 6

Fat transfer for lower eyelid bags

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If Juvederm and Restylane injections have made your lower eyelid bags worse, I would not suggest fat injections into this area.  In your case, you may be a better candidate for a traditional lower eyelid blepharoplasty in which the exess skin is removed, the lower eyelid fat pads are tailored, and the connective tissue between the lower eyelid and the cheek is released. 

San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews

Bags under eyes made worse by Juvederm/Restylane need surgery not Fat Transfer

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For any injected material-Fillers such as Juvederm or Restylane as well as Fat Transfer- must be placed beneath the depression below the bag or puffiness of the eyelid to camouflage the eye bag.

This is very difficult to achieve as the tissues in the depression are tightly adherent to the bone of the eye socket.

After 2 failures with filler injections I would avoid attempting a Fat Transfer-if the doctor could not improve the look with fillers it is unlikely any benefit will be achieved with Fat-Fat is just another form of filler.

My approach is a Transconjunctival Blepharoplasty with Arcus Marginalis Release and placing a Fat Graft beneath the depression below the eyelid and removing the fat that is causing the puffiness or eye bag.

See link below for details

Fat Transfer To Lower Eyelids

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The good thing about Juvederm and Restylane is that if you are not satisfied with the results the material eventually goes away. You may not have that luxury with a fat transfer. There may be several ways to improve the features that bother you about your eyelids but they will likely require surgery. Consult your surgeon certified by the American Board of Plastic Surgery for more in depth advise .

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 reviews

Bags after HA fillers. Would fat transfer be better?

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  I see that you received two answers which differ from one another.  I do agree that it is difficult to say for certain without reviewing photos or seeing you in person.  But I think you avoid Fat Transfer because of the problems you related.  I would lean toward lower eyelid surgery, with re-draping of the fat over the eye ridge with possible mid face lift.  I believe that you should consider seeing an oculo=facial plastic surgeon for the highest degree of specialization and training.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

Inexact filler placement in the eyes will lead to a bulge

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This can also happen with fat grafting as well. If the filler is causing bulges in your lower eyelid fat grafting placed in the same place will just do the same.  Get multiple opinions on what should be done and their approaches and how to avoid that in you. Take a close look at the results of the surgeons that are seeing. With the bulges from fillers, get them taken out with some enzymes, hyaluronidase.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Juvederm and Restylane Caused Bags Under My Eyes, Would a Fat Transfer be a Better Alternative?

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Thanks for your question. Without examining you I am somewhat limited in my advice, but with that said, the benefit of fat transfer is that it is injected deep in the soft tissue providing a more natural improvement to your tear trough and cheeks.  Injectable fillers have to be injected more superficial for maximal results and therefore, can cause a more lumpy appearance.  I would suggest you wait until all the filler is absorbed and find a Plastic Surgeon with experience in fat transfer to help with your concerns.

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.