Fat Repositioning Vs Fat Transfer for Under Eyes?

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?

Doctor Answers 7

Transconjunctival blepharoplasty and fat repositioning.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Fat Repositioning vs Fat Transfer

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

  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

Photos would be helpful

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Lower eyelid surgery with fat transfer

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Lower eyelid dark circles options

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Fat transfer does not require trans conjunctival blepharoplasty.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}


Just going by your history, fat transfer (no blepharoplasty) with laser resurfacing may be a good choice for you.  The problem is that any lower eyelid intervention is very technique sensitive.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Fat Repositioning vs Fat Transfer in the Lower Eyelids

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If you have excess fullness of the lower eyelids secondary to fat, repositioning is a better procedure. You avoid the risk of an irregular contour with fat injections. If necessary a laser treatment or a chemical peel can be used to tighten lax skin.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.