Which would you recommend; under eye filler or fat grafting?

Question

i am having microfat grafting including under eyes area. . i had bad experiences with fillers due to overfilling or tyndall effect in the past. i am starting to think that perhaps my skin is too thin since fillers show and that fat grafting will result in lumps even though my surgeon is highly skilled in that. shall i do fat grafting to the lower eyelid? do surgeons overfill that area or do they put just enough (i read that the blood supply is good there so what if all fat thrives).

Trevor M. Born, MD · Answer

Dear AngelxoxoxoThank you for your question!  The treatment of the under eye area - can be done with fillers such as Restylane ( the blue color happens when it is put too superficial) or with Micro Fat Grafting- this can give excellent results and lumps/bumps should not occur if it is placed on the deep layer. 1/5 patients may need more fat added after 2 months.  Platelet Rich Plasma is another option- but for volume and correction of the hollow it will most likely take 2 treatments 2 weeks apart.With Warm RegardsTrevor M Born MD

Dilip D. Madnani, MD, FACS · Answer

Hi, without seeing pictures, its hard to tell. If you go to my Facebook/instagram drmadnani, you will see lots of pictures with under eye filler treatments using filler and my website shows pictures using fat grafting. Other options include skin resurfacing. Pictures and an exam will be helpful to provide the best advice and having an experienced injector is the most important piece of this puzzle. As far as the fat goes, the under eye area is filled to slightly more than needed. When done correctly, lumps are quite rare, the initial swelling is obvious for the first 7-10 days, after which it should look great and continue to heal over the next few months. Pain is minimal, bruising varies and ice packs are important for the first 24-48hrs. Good luck!

John J. Martin, Jr., MD · Answer

You will always appear a little overcorrected initially due to swelling.  Even with good blood flow there will be some resorption of the fat.  Most surgeons will be using a larger volume of fat than they would an HA filler because of this. If you had issues with overfilling before, you may have had Juvederm put in which can swell more than some of the others, creating overcorection and tyndall.

Samir Shureih, MD · Answer

In the tear trough fat grafting needs to be precise and do not over-correct. If need be a second session can be done. May be more expensive, but better than overfill and the difficulty of correcting that

Which would you recommend; under eye filler or fat grafting?

Answers (4)