Filler or fat transfer? (Photo)

Question

I have a tear trough under my right eye and it's bothering me. It's due to volume loss from my cheek bone apparently. Would filler do a better job or would a fat transfer do a better job what would you recommend? I'm 27 and have had this for years now.

Anna Chacon, MD, FAAD · Answer

Thank you for your question and for sharing your concern. Both fillers and fat transfer are viable options for addressing tear troughs and volume loss under the eyes, and the best choice depends on several factors, including your specific anatomy, desired results, and personal preferences. Here are some insights to help guide your decision:

Dermal Fillers:

Quick and Minimally Invasive: Fillers, such as hyaluronic acid-based products (e.g., Restylane, Juvederm), are quick to administer and involve minimal downtime.
Immediate Results: The results are visible immediately after the procedure.
Temporary Solution: Fillers are not permanent and typically last between 6 to 12 months, depending on the product used and individual metabolism.
Reversibility: One advantage of hyaluronic acid fillers is that they can be dissolved if the results are not satisfactory.
Fat Transfer:

Natural and Long-Lasting: Fat transfer uses your own body fat, which is harvested from another area (like the abdomen or thighs) and then injected into the tear trough area. This can provide a more natural feel and longer-lasting results.
Potentially Permanent: While some of the transferred fat may be reabsorbed by the body over time, a significant portion can remain permanently.
More Involved Procedure: Fat transfer is a more invasive procedure compared to fillers, involving liposuction to harvest the fat, which means a longer recovery period.
Considerations:

Age and Skin Quality: At 27, your skin is likely to be more elastic and resilient, which can make both treatments effective. However, the choice may also depend on the extent of volume loss and the condition of your skin.
Desired Duration: If you are looking for a long-term solution and are comfortable with a slightly more involved procedure, fat transfer might be the better option. If you prefer a less invasive approach with the flexibility to adjust the results over time, fillers could be ideal.
Consultation with a Specialist: Ultimately, the best way to determine the most suitable option is to consult with a board-certified dermatologist or plastic surgeon who can assess your specific needs and provide personalized recommendations.
Both treatments have their own advantages, and a specialist can help you weigh these based on your goals and lifestyle.

I hope this information helps, and I wish you the best in achieving your desired look!

Best regards,

Eric M. Joseph, MD · Answer

If you are concerned by the small group underneath the fat pad of your eye, depending on your examination, this may be filled permanently with microdroplet Silikon-1000. Other fillers may be considered as well. Please ensure that your doctor is facile in the use of fillers in this very delicate area. Thank you for your question. Sincerely, Dr Joseph

Nelson Lee Novick, MD · Answer

While the allure of a permanent result is certainly understandable, the problem with fat grafts (and with permanent fillers, for that matter) is that they are permanent and that adverse reactions to them, such as the formation of lumps and nodules can be very difficult to treat. In the case of fat grafts, since the fat grafts retain the characteristics of the region from which they were taken (i.e. belly, thighs, hips), with the passage of time, just as one can develop a midriff bulge, so can the fat injected into the cheeks. Fat injections are also an expensive, miniimally invasive procedure with downtime. One step requires large cannulas to withdraw fat from the thighs, buttocks or hips and a second procedure to inject it under the eyes.
On the other hand, the use of a robust, off-the-shelf HA volumizing filler appropriately placed in the upper cheeks can create a smoother, more desirable, gradual transition between the upper cheeks and the under-eyes in about fifteen minutes, with immediate results and little to no significant downtime..  Make sure to see an experienced, board certified cosmetic dermatologist. Best of luck.

Camille Cash, MD · Answer

Both grafted fat and fillers are options to help improve the appearance of hollowness under the eye.  The benefit of fillers is that the results are quick with no downtime.  If HA fillers are used they are also reversible if you do not like the look.  The benefit of fillers is that they are permanent, but there is risk of uneven grafting or nodules forming.  I encourage you to begin by visiting with a board certified plastic surgeon to discuss your options and learn more about what is best for you.

Jacquelline Leva, DO · Answer

Both have nice cosmetic outcomes it depends really what you prefer. Fat Grafting depends on your metabolism and current diet, results can be short lasting or long lasting. Dermal filler we know more or less that it will last x amount of time and they do have many peer review studies especially on the allergan products to show that they work on several hundreds of patients.

Leonard Grossman, MD · Answer

Fat and never fillers should be used around the eye area. Fillers in invariably cause problems overtime.
Fat grafting when done properly creates beautiful, natural and practically permanent results. I hope this helps and good luck from Leonard Grossman MD organic Plastic Surgery.

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