Fat Repositioning Vs Fat Transfer for Under Eyes?

Question

I had restalyn in dec 2011 and was unhappy with results, I then had juvederm which some what improved the situation . I am considering dissolving fillers and either having a trans conj blepho with fat repositioning and fraxel laser to tighten and remove dark area and yellow cholesterol deposits OR trans conj blepho with fat transfer. what is the best procedure and what is the difference?

Toby Mayer, MD · Answer

Transconjunctival blepharoplasty and fat repositioning is the best procedure for fat bags and tear troughs. Skin looseness can be treated with chemical peel or laser.

Kenneth Hughes, MD · Answer

Either is acceptable if done correctly.   I think that you will find that this is a function of training and preference and not quality of result.  Kenneth Hughes, MD Los Angeles, CA

A.J. Amadi, MD · Answer

Its hard to answer the question without having your photo to evaluate. If you have good cheek/malar volume, a transconj bleph with fat repositioning might give you a great result. However, if you have a hollow malar region, the fat grafting would give you additional volume needed in the cheek/tear trough region.

	Each patient needs individualized assessment. I use one technique over the other depending on the patient.

	The laser will obviously not address the volume issue, but may be appropriate for xantholasma [cholesterol deposit] depending on your skin tone.

Nima Shemirani, MD · Answer

Dear zany28,

	
		Each surgeon has their own method for making your eyes look better
	
		My preference is using fat transfer and not fat repositioning because it works better in my hands
	
		Additionally, I can use the fat to precisely sculpt the lower eyelid and cheek
	
		After the fat transfer heals, then we may consider a laser for any fine lines left over


	Best regards,

	Nima Shemirani

Mehryar (Ray) Taban, MD, FACS · Answer

Either option may be appropriate depending on your specific eyelid and face anatomy. For one person, the first option might be best while for another person the second option.  See an oculoplastic surgeon.

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