Facial fat transfer-in upper eye area?

Question

I've noticed that everyone focuses on the mid and lower part of the face. What about the fat under the brow bone and upper eye lids? Can this be done to restore that area? Looking to have this procedure done sometime this year (once this COVID19 thing passes). Also, can you overfill (anticipating that most of the fat will be lost).

Tim Neavin, MD · Answer

I LOVE volumizing this area.  Adding fat into the brow and under the brow and hollows above the eye dramatically rejuvenate the face.

Kenneth Hughes, MD · Answer

Hello, thank you for your question. Fat Transfer around the eyes (periorbital area) can improve the appearance significantly and make you look significantly less tired.  However, keep in mind, this the most challenging and tricky areas to get right.  If too much fat is added and you end up looking over-filled, this can be very problematic and not easily corrected. I recommend you to schedule a consultation with a board certified plastic surgeon with skills and experience.

Mehryar (Ray) Taban, MD, FACS · Answer

Fat injection can be done in the upper eyelid area but a more predictable and precise option would be filler injection with semipermanent results. Expertise is important.

Andrew Kornstein, MD, FACS · Answer

The answer is absolutely. We know that age related atrophy of the forehead bone and fat(volume loss under the skin) leads to reduced anti-gravity support and descent of the eyebrow region, this in turn diminishes brow bone and upper lid skin definition. In addition, the upper inner aspect of the brow bone atrophies with age leading to a hollowing and descent of upper lids skin. Depending on your evaluation one or both of these regions will need to be grafted with fat derived stem cells. In terms of predictability and expertise, I published an article in 2005 using Restylane to rejuvenate the brow bone/upper lid region. Subsequently, I have published and presented articles on both forehead and upper lid fat grafting. These techniques make upper lid skin surgery unnecessary and the forehead/eye region more aesthetically pleasing as well as slowing their aging owing to the presence of living stem cells in these areas.  Your instincts were right on. Hope this addresses your question.

Mats Hagstrom, MD (license on probation) · Answer

The answer to your question is yes.Fat transfer can be done around the eyes but it has a fairly high rate of undesirable outcomes.Fat transfer is imprecise and unpredictable in comparison to fillers and I would highly suggest using filler’s instead of fat transfer in this area. I recommend start with fillers to see if you appreciate the changes.Most providers will overgraft to some degree but this leads to the most common problem which is more fat survived than was anticipated leading patients to want fat removed. The post immediately before yours was a patient who is now asking how fat can be removed around the eyes from previous fat transfer.Removing previously grafted fat in this area is technically difficult and I would suggest moving forward with caution with this type of work. It’s better to stay conservative and have a second round of fat transfer if needed.Best, Mats Hagstrom MD

Robert T. Buchanan, MD (retired) · Answer

Yes, you can graft fat to the upper eyelid area. This is, however, a very complex anatomy and demanding area and must be done by an expert. One sign of an expert is that they do not lose "most of the fat." In fact, they should have a 75-80% take of the fat transferred. Many physicians doing fat transfer do it like they are injecting an off the shelf filler, by simply putting the fat into the area until the area is full. This puts large amounts of fat in one place with blood supply only for the outside fat next to the normal tissue. To be successful, the fat has to be injected in thin tubes with a small canula and each tube has to be separated so that each is vascularized. In the eye area, since the tissues are thin, this may require more than one session.

Facial fat transfer-in upper eye area?

Answers (6)

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