A Board-certified, Ivy League-educated oculoplastic surgeon advised that he does not do fat pad repositioning for any patients. Period. He excises the fat pads, and if residual deficits remain, the patient can receive hyaluronic acid fillers. Can I please ask why, in 2024, a surgeon would be against repositioning? Is there still a body of evidence to suggest that it has a high complication rate?
Answer: Please understand that many "aesthetic" surgeons were primarily trained as reconstructive surgeons. They are stuck in the past. They were trained a certain way and never evolve. That training may have been at an Ivy League university but it does not matter. They are basically doing what they were trained to do by their fellowship preceptor. Yes, fat transposition is more work and can be associated with post-surgery inflammation. However at the end of the day, people need volume in their under eye area. I have patients who 20 years after their arcus marginalis release surgery in their under eye and still do not need fillers. Don't expect this surgeon to modernize. Find a surgeon who offers the approach you are interested in, Stick to your guns and don't be gas lighted by a surgeon stuck in the past.
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Answer: Please understand that many "aesthetic" surgeons were primarily trained as reconstructive surgeons. They are stuck in the past. They were trained a certain way and never evolve. That training may have been at an Ivy League university but it does not matter. They are basically doing what they were trained to do by their fellowship preceptor. Yes, fat transposition is more work and can be associated with post-surgery inflammation. However at the end of the day, people need volume in their under eye area. I have patients who 20 years after their arcus marginalis release surgery in their under eye and still do not need fillers. Don't expect this surgeon to modernize. Find a surgeon who offers the approach you are interested in, Stick to your guns and don't be gas lighted by a surgeon stuck in the past.
Helpful 3 people found this helpful
Answer: Lower eyelid fat repositioning may be a tricky proposition. This technique was first described and implemented approximately 25 years ago. One would think that if results were spectacular, everybody who performs lower blepharoplasty would be utilizing this technique. Personally, it does not make sense to me to move orbital fat into an area that it normally does not belong. I hope this helps! Sincerely, Dr. Joseph
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Answer: Lower eyelid fat repositioning may be a tricky proposition. This technique was first described and implemented approximately 25 years ago. One would think that if results were spectacular, everybody who performs lower blepharoplasty would be utilizing this technique. Personally, it does not make sense to me to move orbital fat into an area that it normally does not belong. I hope this helps! Sincerely, Dr. Joseph
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March 22, 2024
Answer: Fat transfer versus fat re-positioning Some surgeons prefer to do fat grafting while others prefer fat repositioning or doing nothing. The concern with fat repositioning is that the fat wants to go back and relapse. I have some friends who are great at fat repositioning and get great results. I prefer to perform fat grafting using fat harvested from the abdomen or thighs. I feel that I have much better control of where I place the fat and there is no relapse possible but there is some fat resorption over time. I believe that creating a youthful convexity is important to obtain the best results.
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March 22, 2024
Answer: Fat transfer versus fat re-positioning Some surgeons prefer to do fat grafting while others prefer fat repositioning or doing nothing. The concern with fat repositioning is that the fat wants to go back and relapse. I have some friends who are great at fat repositioning and get great results. I prefer to perform fat grafting using fat harvested from the abdomen or thighs. I feel that I have much better control of where I place the fat and there is no relapse possible but there is some fat resorption over time. I believe that creating a youthful convexity is important to obtain the best results.
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March 22, 2024
Answer: Why surgeons don’t offer certain techniques Sometimes, all it takes is one patient with a bad outcome to “scare” a surgeon away from trying certain techniques. There is no body of evidence for MOST things in plastic surgery because studies are not well funded for cosmetic medicine, study sizes are small since they are often single surgeon, and results are often subjective.
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March 22, 2024
Answer: Why surgeons don’t offer certain techniques Sometimes, all it takes is one patient with a bad outcome to “scare” a surgeon away from trying certain techniques. There is no body of evidence for MOST things in plastic surgery because studies are not well funded for cosmetic medicine, study sizes are small since they are often single surgeon, and results are often subjective.
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March 22, 2024
Answer: Transconjuctival blepharoplasty It is always individual decision. Most surgeons using transconjuctival approach will combine resection of the excessive fat pads and transposition of the small flaps over the orbital rim to provide some augmentation of cheek/lid junction. We use fat grafts for patient who need it rather than HA filler. Combination of specific procedures is individual choice which depends of the patients needs but also, surgeon’s preferences. Hope this helps.
Helpful 1 person found this helpful
March 22, 2024
Answer: Transconjuctival blepharoplasty It is always individual decision. Most surgeons using transconjuctival approach will combine resection of the excessive fat pads and transposition of the small flaps over the orbital rim to provide some augmentation of cheek/lid junction. We use fat grafts for patient who need it rather than HA filler. Combination of specific procedures is individual choice which depends of the patients needs but also, surgeon’s preferences. Hope this helps.
Helpful 1 person found this helpful
