Blepheroplasty options. (photo)

What options are there for replacing the fat under my eyes. I'm not too interested in fat injections or artificial fillers. I would like a surgical treatment to place fat in the dark areas (upper cheeks and undereye region).

Doctor Answers 4

Dark Circles, Eyelid Wrinkles/Bags -- Restylane or Belotero, Laser C02/Erbium Resurfacing, Microneedling, Viva/Intensif, Fraxel

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I suggest fat repositioning and lasers to get the best outcome. I suggest you see an expert.  Best, Dr. Emer.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 203 reviews

Lower blepharoplasty for under eye fat bags

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The best method for treating under eye fat bags is transconjunctival lower blepharoplasty with fat repositioning which is long lasting and gives smooth natural under eye appearance. Best to see an oculoplastic surgeon for evaluation. See following video and link too.

Under eye options

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You don't need an incision to place fat on the cheeks.  The fat actually works best with an injection made through a very small hole that heals quickly.  So, if it's fat you're wanting, then don't obligate yourself to an incision.  I'd say based on your picture you may want to start with that option, as it will help add volume to your cheeks and also hopefully help with the blue hue at the tear trough area.  Other surgical option is a lower lid blepharoplasty, through a trans-conj incision (hidden) and redraping of the lower lid fat pads, anchoring these to the cheek to fill in the step off at the malar groove or tear trough.  Same basic result as the fat grafting, just depends on your anatomy and severity.  

Lower lid Blepheroplasty

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The pictures posted is not enough for evaluation.

If there is herniated fat in the lower lid, then a blepharoplasty where herniated fat is re-distributed over the infra-orbital rim, detaching the medial orbicularis fibers will soften and improve the tear trough

Samir Shureih, MD
Baltimore Plastic Surgeon

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