Is 5 Milliliters of Fat Too Much to Add Under One Eye? is This Fat Transfer Procedure Correct? (photo)

Question

1 Should I ask the surgeon to do an abdomen evening by extracting more fat? Will the fat grow back on it's place?. 2 I have under eye bags now, is it oil or muscle swollen? How fast will it go away? Do I need manual drainage? Can this be undone in case it doesnt go to a normal stage? Is 5 mililiters dangerous or too much injected under each eye muscle (in 5 6 points)? Fat was injected only after a short drainage and wash with serrum. Thank you for helping ! Dorian

A.J. Amadi, MD · Answer

5 ml of fat is not too much if the fat was distributed along the cheek underneath the eyelids, which from the photos seems to be the case. But when it comes to the eyelid itself, I do not place more than 1-2 ml in the tear trough region. The eyelid skin is quite thin, and any more than that, and you risk getting visible lumpiness.

	You seem to be doing quite well, and be patient with the swelling.

Nima Shemirani, MD · Answer

Dear Lucian,

	 

	We overinject the amount of fat at first because about half of it goes away as it heals.  The amount that stays varies, but we would place enough so that you have a nice result.  Bags are to be expected 4 days after surgery and can last for a little while longer.  I would keep ice on it afterwards, the swelling will come down.  You look like you should look like by the 4th day, I wouldn't manually massage the area too much.

	Best,

	Nima Shemirani

Richard Ellenbogen, MD (retired) · Answer

I just returned from the ASAPS meeting in Vancouver and saw a course in periorbital fat grafting.by who I consider besides myself the best fat grafter in the US. His handout sheet had 5 or more cc of fat in the various areas around the lower eyelid and his results after waiting the required period were sensational. I generally use that much in many cases or less.. Wait..I think you'll be surprised,

Yoash R. Enzer, MD, FACS - Account Suspended · Answer

Fat is an excellent filler product, and I have recommended its use in the face to restore volume for 20 years. Your photos show a very shallow midface, with a so-called negative vector of the eye-to-cheek.   There are several options for dealing with this problem, including onlay implants, cheek lifts, and fat transfer or synthetic fillers.  Even as a plastic surgeon who specializes in eyelids, I am very leary about placing fat close to the eyes.  The skin is very thin, and thus the fat can often look lumpy.  This has caused countless complications and many patients have wished the fat was not placed there.

	 

	I do have to say that, based on the photos, your doctor did a heroic, but fantastic job trying to build up the upper cheek, so as to camouflage the negative vector.  It is perfectly normal to have swelling after a fat transfer procedure, sometimes for weeks.  It is always important to see your doctor after the surgery so he/she can check your progress and reassure you that everything is healing properly.

	 

	Yoash Enzer, MD

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