Can fat transfer under the eyes help with scleral show and flat midface? (Photo)

Question

I have excessive scleral show and fat underneath my eyes and a flat mid face.Can this be corrected by fat transfer under eyes as it makes my eyes and overall face look tired Thank you!

George Bitar, MD · Answer

For the scleral show, I would advise a canthopexy, which is a surgical procedure to lift the corner of your eyes. When performed with a lower eyelid lift, fat along the lower eyelids can be redistributed for a smoother contour. Fat can be added for volume in the cheeks. However, fat alone will not correct the downturned corner of the eyes. Hope that help!

Ayse Dolar Bilge, MD · Answer

Lower eyelid lifting with canthoplasty can help. Fat injection can't solve scleral show problem. Best Regards

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment we need full face standard pictures. Look at how plastic surgeons take before and after pictures to get an idea. Basically we’re looking for mug shots showing a full frontal face and sideways view including the full face without facial expression.

Mid face volume can be achieved with implants,  a mid-facelift(very different than a facelift), Fillers or grafting fat

Of all of these grafting fat is probably one of the hardest and most unpredictable. Fillers are in comparison to fat grafting very precise, predictable and forgiving.

Managing fat transfer if people are not happy with the results can be very difficult.

A canthoplasty or Canthopexy may be an option for the scleral show.

In the end finding the right plastic surgeon is probably even more important than what procedure you choose.

There are different options and each, with its advantages and disadvantages.

Provider selection is paramount when it comes to both helping you choose the right procedure and having consistent quality outcomes.

To find the right provider I suggest having multiple in person consultations with local experienced board-certified plastic surgeons.

Ask each provider to show their entire collection of before and after pictures of patients who’ve had mid face volume correction using all the various treatment options each provider recommends.

For fat transfer make sure after pictures were taken at least three months from the date of the procedure. Early fat grafting results can look very impressive but do not at all represent final results.

When choosing between Fillers and fat transfer my recommendation is patience start an opt for working with fillers despite the need for ongoing treatment.

If you opt for grafting fat then make absolutely sure you’re surgeon has the scale and experience needed.

Facial fat transfer is a highly complex procedure that takes years of experience to master.

Best,

Mats Hagstrom MD

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