1 undereye bag remaining: 5 months post transconjunctival blepharoplasty with fat repositioning. (photo)

I have posted regarding this dilemma a few times. I spoke AGAIN with my surgeon. I was now told to wait 1 year and reassess. I was also told that we can't expect "perfection" which I think was a very disregarding response to my concerns. My surgeon also said that there may be nothing we can do without possibly making it worse. I feel that perhaps I am dealing with an inexperienced person here. Any advice? I am very upset.

Doctor Answers 4

Under eye bag

Thank you for your question.  Asymmetry after surgery is not entirely uncommon, and can happen in the best and most experienced hands and surgeons.  There is no harm in waiting longer to allow ample time for healing occur.  Should your condition remain and not improve, further treatment options would include dermal fillers to the area to camouflage the bulge, versus surgical revision to remove or reposition the excess, bulging fat from the lower eyelid.  


Newport Beach Oculoplastic Surgeon

Revision lower blepharoplasty fat pad

It is unlikely that things will change much after 5 months from surgery. Your surgeon may or may not be correct in regards to further treatment. Best to see an experienced oculoplastic specialist for evaluation. Possible treatment options include revision lower blepharoplasty or filler injection.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 62 reviews

1 undereye bag remaining: 5 months post transconjunctival blepharoplasty with fat repositioning.

Hello Bags13,

One of the issues with fat repositioning is it is more prone to having excess fat remain.  The reason is that at the time of surgery your surgeon decides how much to remove and how much to reposition.  Since all of the excess isn't removed but rather a portion repositioned, it can leave some slight fullness afterwards.  You are now 6 months out.  I agree that there could still be a little bit of improvement up to a year, but with the amount you are seeing you aren't likely to get much further refinement.  There are options to help out that area.  This may involve using temporary fillers to better camouflage it or even a tuck up surgery to simply address that bag.  It is always best to follow the advice of your surgeon, but if you aren't happy with the answers and the progress you have been making, then consider getting a second opinion from a facial plastic surgeon or oculoplastic surgeon.   

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Residual fullness following a transconjunctival blepahroplasty

Since the pre op pictures are not available it is difficult to explain the residual fullness of the left lower eyelid in this patient. Certainly additional fat could have been taken. The amount of fat to be removed however is largely a judgment of the surgeon at the time of surgery. If too much fat is removed then the patient develops a "hollow eyed" look. Short of redoing the blepharoplasty, the patient might benefit from some minor filler material and laser tightening of the skin.

Richard O. Gregory, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 11 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.