Is it possible my doctor removed only fat and no skin? (Photo)

Question

I am really scrutinizing my blepharoplasty since it didn’t turn out how I wanted and seems to have aged my face more actually. Are there any tell tale signs that they just removed fat and not skin? Or does it Sometimes seem that way because the volume they removed along with the skin negated the skin removal? Hopefully that makes sense. I was told they would remove excess skin and just enough fat as to not make my lowers look hollow.

Jeffrey M. Darrow, MD · Answer

It is likely that both fat and some skin were removed for both your upper and lower eyelids. Both your upper and lower eyelids show a significant decrease in the subcutaneous fat and therefore some skin must’ve been removed in order to contour that loss of volume. The lower eyelids typically have less skin removed so that there is not a problem with lower eyelid retraction. Your surgeons operative report should tell you clearly what they did. Best wishes.

Gary M. Horndeski, MD · Answer

Yes, it is possible.  Usually with lower blepharoplasty, the fat is transposed and not removed.

Best Wishes,

Gary Horndeski, M.D.

Mats Hagstrom, MD (license on probation) · Answer

Twist, of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures. 
If you don’t have proper before, and after pictures and ask your surgeon to forward, the pictures they took.
You are squinting in your preoperative picture and this changes the appearance considerably.
I’m not sold that you needed a lower eyelid blepharoplasty at all.
Your preoperative picture does not show clear evidence of bulging lower eyelid fat pad.
I generally do not recommend removing skin or ocularis muscle from the lower eyelid.
Doing so predisposed people to a premature ectropion.
Treating wrinkled lower eyelids it’s inherently difficult, and in the end, there really is no excellent treatment for excessive sun damage which causes premature aging.
Prevention is the key with the use of sunscreen and avoiding excessive sun exposure but this needs to be started early in life.
If anything I question if you should have had the procedure. 
I don’t think it was done poorly. I just don't think it should have been done. 
People have a hard time accepting what they look like in the mirror. 
The key to quality plastic surgery is always based on first and foremost having a clear understanding of the problem. Until that has been done no one is in a good position to prescribe an operation. 
Sundamaged of the lower eyelids is an inherently difficult problem to treat. Unlike the upper eyelids you can’t just remove skin to tighten it. The lower eyelid does not have the integrity to support skin tension. Any real attempt at surgical skin removal to the point of removing wrinkles will be met with a very difficult to treat problem. Premature ectropion. I think you should count your blessings your surgeon did not remove more skin. 
Best,
Mats Hagström, MD

Is it possible my doctor removed only fat and no skin? (Photo)

Answers (3)