Is a fat transfer absolutely necessary with a lower blepharoplasty?

Great question!  It all depends on what you look like - most patients do not need fat transfer with the lower blepharoplasty.  However, if you have any hollowness under the bags, then often times I do recommend fat grafting with the blepharoplasty, because once the bags are out, it can make the hollowness look worse.  You could also do this at a later time if you would like to see how your results will turn our first.  Its a discussion you should have with your surgeon as there are pros and cons to each side.Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

Different doctors will have different opinions on this. I am not a fan of fat transfer to the lower eyelids as I find the results can sometimes be unpredictable. I usually recommend fat removal and then use fillers to blend the eyelid-cheek junction 6-8 weeks after surgery if needed. Injected fat is extremely difficult to remove if the results are not optimal and the under eye area is very unforgiving. I think fillers are a better option here.

Hi and thank you for your question. Yes, it’s optional, and can be done at a later time; that said, ensuring the best result requires seeing the patient, and finding out her goals. Surgeons use different techniques to achieve the same goal. Fat transfer is one option, as is transposition of fat from your lower eyelid, and the best technique depends on your unique anatomy. In your case that very well may be the best plan.

Thank you for your question - unfortunately, it is impossible to say for sure without seeing you in person in my office. In some cases, fat transfer is an essential part of the process because it can restore volume to areas that have hollowed over time. Blepharoplasty cannot achieve this goal alone. In other cases, fat transfer is not completely necessary to achieve a refreshed appearance. Make sure you are working with a board-certified plastic surgeon who is well-versed in blepharoplasty techniques to ensure an optimal outcome whether or not you opt for the fat transfer addition. 

It's not necessary but fat grafting can improve your results if done properly. We lose volume in the midface as we age - fat grafting replaces this lost fat, but it is not strictly in the same location as the lower lid bags.

Lower blepharoplasty can certainly be done without performing fat transfer at the same time.  Without examining you, it is impossible to say if it is necessary in your case. Fat grafting is used to restore volume in lower lids where it has been lost. Some potential complications include lumps or bumps, as well failure of the graft to take. If fat grating is necessary to achieve a good result, I would definitely recommend doing it at the time of the blepharoplasty for best results. If you are uncertain about your treatment recommendations, obtain a second opinion from an experienced plastic surgeon.

Dear Lisa.777The short answer is that it depends. Fat repositioning blepharoplasty preserves volume and redistributes it to the upper cheek, so in young patients (20's and 30's) it is possible to get a great result with just the blepharoplasty because there has been minimal cheek volume loss (usually). However, once you get into your 40's and 50's, almost everybody has lost significant volume in the cheeks, so that just repositioning the eyelid fat is not going to give enough volume, and additional fat transfer would be required to get the ideal result.Having said that, you certainly can stage the procedures if you would like, and some of my patients choose to do that. Most of those patients will tend to come back in for additional fillers because they end up recognizing that additional volume makes them look better. This happens because the lower blepharoplasty  often creates a temporary volumization of the cheeks which the patient will miss when the swelling goes away. Do what is right for you! If you aren't ready for fat transfer, just do your eyelids. You will still be happy with the improvement.

You absolutely do not have to do a fat transfer with a lower blepharoplasty.  If you decide later on down the line that you would like to have that done, then you can do it at a later time.  You can also use filler in the area.  I recommend that you consult with board certified plastic surgeons on your area to discuss your options.  I wish you the best of luck on your journey!

NO. Most patients do not need any additional volume augmentation (fat or filler) if lower blepharoplasty is done with repositioning of the eye fat bags to the surrounding hollow area. Need evaluation for more accurate individual answer.

Fat reposition with blepharoplasty? Photos are needed to answer this for you. If needed the time to do this is with your blepharoplasty since we have the excess fat to use.