Lower Blepharoplasty to Remove Fat. The Doctor Didn't Remove the Fat?

I paid for a lower bleph to remove fat for puffiness under the eyes.Puffiness worse even after 6 months.He said to be patient,since I was 70 and had a blepharoplasty about 20 years ago causing slower healing.After a year no improvement.He injected Kenalog, which made the swelling worse.I obtained two other opinions and was told fat was not removed.Six months later Kenalog swelling still worse.He now wants to make small external incisions to take out some of the fat.I'm not comfortable with this.

Doctor Answers 4

Lump after fat injection

Assuming the lump is residual fat, options are available after kenalog failure.  One is injection  of more powerful medication (5FU).  Surgical removal may be valid too, which is best done from inside the eyelid approach (transconjunctival) although at times external approach may be best.  See an oculoplastic surgeon.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Lower Blepharoplasty to Remove Fat. The Doctor Didn't Remove the Fat?

If you only need fat removed, I would recommend you go through the inside of the eyelid so that you don't develop possible complications like lower eyelid retraction.  This is known as transconjunctival blepharoplasty.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon
4.7 out of 5 stars 16 reviews

Blepharoplasty revision

The previous surgery does not slow healing and kenalog may soften scar tissue but can be unpredictable if you are using it to kill fat cells. You have already seen 2 other surgeons and have lost faith in your original surgeon. The natural conclusion would be to transfer your care to one of the other surgeons who has already seen you. A specific surgeon may not be the best surgeon for all comers for a variety of reasons.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Lower Lid Bleph For Baggy Eyes

Dear Nancy, 70 is not old.  Having had a blepharoplasty 20 years ago does not slow down wound healing one bit.  If you still have bags under your eyes 18 months after surgery, something definitely has gone wrong.  I believe the practice of injecting Kenalog around eyes is very, very dangerous as it might lead to serious depressions under your eyes.  I believe the physician who did the surgery meant well and did his best, but it appears his best is not good enough. 

It's time to seek out a Board Certified plastic surgeon who has experience in facial cosmetic surgery with specific emphasis on lower eyelids.  You are very fortunate California has some of the best plastic surgeons in the world.  Minimum requirements are memberships in ASAPS and ASPS. 

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.