Planning on having a facelift in 2015. Dr suggested removing the fat pads by my nose. Do you think it's necessary? (photo)

I'm 58 and had two previous blepharoplasties . Upper and lower. The second surgery was three years ago to fix the problems with the first bleph. Will there be a lot of scar tissue that will make it more difficult? I'm don't want my eyes to look skeletonized. Will there be redundant skin if just the fat pads are removed?

Doctor Answers 22

Facial fat pads

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deflate and descend and one gets older. There are very few indications for removing facial fat in rejuvenation other than superficial under chin or jowl fat. A good facelift will reposition your fat pads to a more youthful and pleasing position. I would not let anyone remove them!

Removing upper eyelid fat pads

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you certainly don't have any protruding fat affecting the appearance of the outer segments of your upper eyelids but there is a little fullness of the pads near your nose.

Although removal of a little of the fat of those pads would produce a slightly better balance of the upper lid fold the risk is that removal of too much will give your upper lid a hollow or skeletonized appearance.

If you went ahead with reduction of those fat pads it is unlikely that scarring in the area would cause major problems and resulting loose skin is unlikely as well.

If the appearance bothers you then go ahead but personally I don't think it is a major issue.

Douglas McManamny, MBBS, FRACS
Melbourne Plastic Surgeon

Natural Volume Lifting

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Thank you for your question.

In your particular case, I would not recommend removing any additional volume around the eyes. The process of performing lower eyelid surgery has changed relatively dramatically over the last decade.

Most facial cosmetic surgeons have shifted the practice away from removing fat toward preservation and restructuring. So many patients become quite thin with exposed bones around the eye socket. Many patients may not have access skin or fat after surgery, but they still may not resemble a more useful picture 10 to 15 years prior.

In your particular case, I would recommend that you consider adding additional fat carefully around the eye socket.  I have been utilizing this technique over the last 10 years in patients with great long-standing results. fat grafting around the eyes, particularly the lower eyelids, is tremendously successful. This technique allows for a very refined and accurate reconstruction. Fat cells transplanted to this area tend to have exceptional longevity bowling to the proximity of the fat cell to the vascular muscular tissue around the eye itself.

I would consider a facelift in conjunction with a natural fat lift. In my particular practice, we refer  to this as natural volume lifting. It is a vector correct lift that elevates the cheek into its more useful position while adding volume as needed.

 I would seek consultation with at least two specialists  with experience considering all options. You should have an exceptional outcome.

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Planning on a facelift, should I also have fat removed?

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From the pictures that you have provided I do not see any need to remove fat. If anything, I think you could benefit from the addition of fat to your cheeks, especially in the region under your eyes. This would create a very nice, natural, three dimensional effect and would compliment your facelift surgery very nicely.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon

Facial fat pads?

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Hi.  Looking at your photos, it looks like the eyelid fat has already been removed.  I do not see a prominent fat pad anywhere in the area - and would recommend leaving it alone.

Planning on having a facelift in 2015. Dr suggested removing the fat pads by my nose. Do you think it's necessary?

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Hi. Quite frankly I do not see the redundancy of fa that you are alluding to. Perhaps its the way the photo is taken. You aready have noticeable upper lid scars and therefore I would be very cautious when proceeding to remove any more fat. Good luck

Question of eye fat pad

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First I do not see a very noticeable fat pad by your inner eyes. And even if there is one it can easily be removed from inside without creating another eyelid incision. I cannot tell about your face from the limited photos but suffice it to say I do all my facelifts with oral Valium and local anesthesia in 2-3 hours. This is a complete facelift and leaves out nothing . The results are fantastic ,incredibly safe, and the recovery is simple. I have done thousands this way and the patient response is excellent

I see no reason for further eyelid surgery.

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I'm not really sure what you mean by fat pads near the nose but the eyelids look hollowed out in probably would benefit from a filler not surgery.

Fat removal

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Thank you for your pictures.   Even though you have a blepharoplasty before I think you do have a contour deformity due to the fat of your upper inner eyelid. I think that would improve your aesthetic contours/appearance of your upper eyelid. 


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During your consultation your surgeon would have pointed out exactly what he is referring to, explain how it is done and give you an idea of what the results would look like.  You would be shown some before and after pictures to help you understand what the procedure does.  Based on that information, it is really up to you to decide if this is something bothers you, results would be something that you would like, and the improvement is worth the risk of surgery on the area, risk of complications, or the risk that the results may worsen an area that may not have bothered you in the first place.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 518 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.