Do you think I should ask my Dr. if she can do a "revision" on my lower bleph? (photo)

I had fat removed from below my eyes. The scar healed very well. I feel like I don't see a difference after five months, and am blaming myself for my after care being lacking.

Doctor Answers 2

There is improvement on the size of the bags, but nothing for the tear troughs

Hi Peaceiful,

There is some reduction in the size of the lower eyelid bag.  It appears that any additional fat or skin removal may lead to an ectropion which is when the lower eyelid pulls down and away from the dark part of your eye and shows too much white of the eye.  Your right eye appears to be slightly lower than it was prior to surgery.  I would worry that simply taking more fat and skin out would pull both eyelids down even further.

The eyebags appear flat enough to simply fill the groove between the upper cheek and eyebag.  This groove is called a tear trough.  Typically a 1-2 cc's of Restylane can provide quite a bit of improvement than most people realize.  It also lasts much longer than patient realize, since many have already tried Restylane in their lips or smile lines and only had it last 4-6 months.  In the lower eyelid area, it last closer to 12-18 months in my experience before my patient return for a touch up.  When they come back for a touch up, they usually use a fraction of the volume that they used in the initial injection.  They also don't wait until all of the filler is gone before they come back.  This is usually around the 12-18 month mark.  If they were to wait for all of the filler to be absorbed, my guess is that it would be longer than 24 months and it would vary from patient to patient.

If you click on my web reference link, I have an example of what fillers can do for a moderate to severe eyebag without any eyelid surgery or midfacelift.   My goal is to make the cheek appear to blend seamlessly with the lower eyelid area, so that you cannot tell where one ends and the other begins.


Dr. Yang

New York Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Fat removal alone does not correct the hollow below the eyelid

Standard transconjunctival blepharoplasty does not correct the hollow beneath the bulge, the orbitomalar sulcus and tear trough. Other procedures can correct that. My procedure of choice is a midface lift. Your result is certainly suboptimal. You should ask your surgeon to show you pictures of other patients he/she has treated with your kind of eyes who got good results. If the doctor does not have pictures of successful procedures on patients like you, you need to find another surgeon. 

Jeffrey Schiller, MD
Edison Oculoplastic Surgeon
5.0 out of 5 stars 11 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.