What would be the smartest thing to do about the fat under my eyes? (Photo)

Three years ago I had lower blepharoplasty and a fat transfer to the area under my eyes. Unfortunately the fat was not applied evenly. Therefore I now have fat lumps under my eyes forming a noticeable line between the circles and my cheeks. I have lost faith in my doctor since he can not see any problem. What would be the smartest thing to do? Do I need more eyelid surgery? Should I have fat taken out or is it possible to even it out? Would some kind of filler might help me? Thank you.

Doctor Answers 14

Still have fat under my eyes after a lower eyelid blepharoplasty and fat transfer

Sorry to hear about your frustration.  Speaking from personal surgical experience trying to help patients with this problem, this can be a challenge to address.  The transferred fat is different from your original fat in your lower eyelids.  It can scar in place, be present in unusual anatomic planes, and be hard to remove or smooth out.  It can be done, but you really need to see a highly experienced eyelid plastic surgeon ideally with experience dealing with this issue and revision cosmetic surgery.  There is hope, but be very careful before proceeding and realize that your expectations may need to be pulled back a bit and the recovery may be longer and it is possible more than one surgery may be needed.  You might consult with Dr. Kenneth Steinsapir, who practices in the LA area.  Best regards.

Colorado Springs Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

Revision blepharoplasty for irregular fat bulges.

Revision blepharoplasty for irregular fat bulges Is what will give you the best results with this common problem. If u add filler it will just look like s bigger bag.  See a very experienced revision blepharoplasty surgeon for the best results. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Uneven fat bags after surgery

Thank you for your photos. Due to your previous surgery and uneven fat distribution, the safest and most effective method would be to have a revision lower blepharoplasty to expose the "fat lumps" and remove only the areas which are uneven or excessive. Excess skin, if any, can be taken out at the same time. Filler are gel-like and would not be the best plan at this time because it they are temporary and it is also difficult to spot-fill tiny areas where the fat is uneven. It is best to have an in-office examination to determine the best incisional method and to specific areas of fat which need to be manipulated. Hope this helps!

Johnson C. Lee, MD Plastic Surgery

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 14 reviews

Fat under eyes

You have the classic appearance of lower eyelid fat pockets. A lower eyelid blepharoplasty will give you a rested and rejuvenated appearance.

Malcolm A. Lesavoy, MD
Beverly Hills Plastic Surgeon
3.9 out of 5 stars 11 reviews

Lower bleph

This is the reason that I don't do fat transposition... because patients aren't happy after and see the fat later on in my opinion.   You need a lower bleph with removal of the fat pads.  That's what will improve your lower eyes.  You have some skin to remove in the lower lid.  Best to go to a board certified plastic surgeon who does lots of eyes.  You should do very well. 

Andrew T. Cohen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 44 reviews

What would be the smartest thing to do about the fat under my eyes?

The fat can be removed and or re-positioned. Also, it may be there is muscle hypertrophy that contributes to the fullness under your eyes. This can be thinned.

Fred Suess, MD (retired)
San Francisco Plastic Surgeon
4.5 out of 5 stars 8 reviews

When lower lids remain lumpy after fat grafting

your options include additional nanofat grafting to fill in any defects/concavities, procedures to take down the prominent pads/grafts (liposuction or thermi ablation), or use of fillers but that will have to be repeated on a regular basis.  A redo blepharoplasty with fat manipulation could be entertained but I would think that would be very unpredictable.  See a surgeon and discuss all options and risks and then choose what is best for you.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Fat lumps after fat injection and lower blepharoplasty

It is important to see an experienced cosmetic oculoplastic surgeon. Options include revision lower blepharoplasty with fat removal vs. filler injection to camouflage bumps vs combination of above.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 74 reviews

Fat transfer in the face

I'm sorry to hear about your experience- fat transfer to the face is a very popular technique, though your situation is exactly why I don't do it.  The fat from your previous surgery will need to be addressed surgically, and I agree with others here that you should be evaluated by an experienced surgeon who has experience with revising fat grafts.  I think you can likley achieve a nice outcome with revision, but unfortunately further surgery will be the only way to address the issue.

Best wishes, 

Dr. L

Adam David Lowenstein, MD, FACS
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 56 reviews

What would be the smartest thing to do about the fat under my eyes?

I'm sorry to hear of your problem. The area can be revised surgically but it is not easy so be sure to choose an experienced surgeon. Even with that surgery it may be necessary to look a having filler for camouflage.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 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.