Nano fat transfer under eyes in orbital area (not tear trough) - will it add volume to the area?

Question

Will nano fat transfer done in multiple sessions add volume to an area? Or will only traditional fat grafting do that? Are there certain techniques that can be used to lesson the likelihood of lumps when transferring fat to the orbital area? Not the tear trough.

Tim Neavin, MD · Answer

Nano fat describes a process where fat is thinned out enough to allow it to be injected directly into the dermis to improve skin.  The process kills most of the adipocytes (fat cells) but does not kill the stem cells (cells that rejuvenate).

For volume, you do NOT want to inject nano fat.  With proper harvest technique (gentle negative pressure) and instruments (less than 1.5 mm holes) and injection technique, (less than 1 mm holes)  you should not get lumps.  I have performed hundreds of transfers and have never had a nodule form in the orbital area.

Ajaya Kashyap, MD · Answer

Thankyou for your query. Nano fat grafting has the advantage of filling up the area with minimising the risk of lumps, which are more common under the thin eyelid skin. Traditional or micro-fat grafting is preferred in the cheek and other areas of the face although both techniques can add volume. Most of the patients need a single session of either treatment although some may need two or more sessions. Please find an experienced board certified plastic surgeon who can examine you and help you with all your concerns. All the best!

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi Katy! Nanofat is very thin and I use it mostly for stem cells and growth factors in areas of scarring. I don't find it ideal for any sort of volume. Microfat is slightly larger and is often ideal for finesse in areas which may show lumps. Traditional macrofat tends to "take" the best long-term in my experience, though the risk of irregularities is higher if not done correctly. If you're talking about adding fat along the lower orbital rim, that can be done which is above the tear trough. Going above and toward the lower lid is very risky from a safety standpoint and the risk of irregularities is much higher as the skin is incredibly thin. I would not advise going higher than the lower aspect of the orbital rim. Hope this helps!

Mats Hagstrom, MD (license on probation) · Answer

Any area around the eyes is technically difficult and prone to having undesirable outcomes like fat necrosis with visible lumps.
The area is very thin and Lacs sufficient host tissue to support the grafted fat in a manner making it an easy consistent procedure.
You can think of nano fat another fancy terms as being marketing tactics. If you insist on having fat transfer then the only important variable is finding a surgeon who has done this enough times that they can accurately and predictably deliver consistent quality results.
For fat transfer after pictures need to be taken at least three months from the date of the procedure. Ear results are not at all representative of final results.
Someone who is highly experienced should be able to show you an impressive collection of before and after pictures. I would say someone who has a lot of experience should have no problem showing you at least 50 sets of before and after pictures for the procedure.
I suggest relying exclusively on in person consultations at which time you should ask each provider to show their entire collection of before and after pictures. ask the provider to show you examples of excellent outcomes, average outcomes and outcomes were people had problems or complications so you see what that looks like.
For technically difficult areas I highly recommend patients stay with fillers.
One’s grafted removing fat due to undesirable outcomes is difficult and often requires open surgery.
There are providers who have enough experience to be able to do these type of procedures well but most providers do the procedure infrequently enough to ever master it.Compared to fat grafting fillers are precise, predictable and forgiving.
There are long lasting fillers for those who don’t want to have repeat treatments several times a year.
Best,
Mats Hagstrom MD

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