Lower blepharoplasty or RF Microneedling for exposed pad & severe hollows under eye? (Photos)

Question

I'm trying to treat a new under eye concern. After having filler dissolved in the tear trough, I have an exposed pad and pretty severe hollows under the eye. Two options have been suggested to me - (1) lower blepharoplasty, or, (2) Morpheus8. I'd really like an opinion on which option would best address my concerns. Thank you so much !

Chet Mays, MD · Answer

Thank you for your inquiry! By your photos, you're a great candidate for a lower bleph with fat transfer to your tear trough which is a more permanent solution than fillers to decrease fullness and help fill the hollowness. We would love to meet with you in person or virtually to discuss your options in depth. Schedule a consultation with a Board-Certified Plastic Surgeon like myself to help you reach your goals and create a surgical plan for you.

Thomas A. Mustoe, MD, FACS · Answer

You have volume loss and a very noticeable transition between mental fat and cheek fat. Through a lower blepharoplasty (transconjuctival) the partition ( arcus marginalis ) between the two compartments needs to be opened and fat transfer used to fill in the hollow. Tightening procedures will not address the underlying problem.

Jill Hessler, MD · Answer

RF micro needling will not treat fat pads around the eyes. While there is much discussion that Morpheaus dissolves fat, this is subcutaneous fat that is immediately under the skin that is lost not fat that is located behind the orbital septum. When eye bags are present along with hollowing, I find a lower eyelid blepharoplasty with a fat transfer is the best long term correction.

Andrew Miller, MD · Answer

Based on your photos, the best procedure would be lower lid fat removal with fat transfer into the tear trough. This can give a long term much smoother and natural appearance to your lower lids. Morpheus will not help. Be sure to see a facial specialist for consultation.

C. Blake Perry, MD · Answer

You are a great candidate for lower lid blepharoplasty with fat transposition. This surgery utilizes an incision on the back of the lid and takes your fat from your lids and moves it to your tear trough and cheek. This smoothes the transition from the eyelid to cheek and gets rid of the “bag” and fills the hollow. Best to see an eyelid expert.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question hereI will start by stating that my answer is based on the limited information and pictures provided , for a more detailed and bespoke plan please consult with a plastic surgeon in person.from the pictures and complaints I would recommend a lower blepharoplasty , morpheus works on the skin and will not address deeper tissues such as the fat pads or tear trough ligament. This can be combined with some fat grafting if needed.
I hope this helps, best of luck!

Gary M. Horndeski, MD · Answer

The best technique for you would be a lower blepharoplasty with fat transposition to fill in the hollows.

Best Wishes,

Gary Horndeski, M.D.

Tanveer Janjua, MD · Answer

No laser can remove or reduce the fat in lower eyelids. Surgery remains the only choice. 
Lower Eyelid Blepharoplasty
The lower eyelids look baggy mostly because of excess fat. This can be removed either by making an incision under the lashes called sub-ciliary approach or from inside the eyelid called Transconjunctival approach. The amount of skin removed has to be minimal as it can pull the lower lid downwards and make it look strange and change the shape of the eye.  All surgeons have their favorite approaches. I like Transconjunctival approach in most cases.
Regards
Dr. J

Emine Demir, MD · Answer

Edema under your eyes is lymphedema  ı will recommend Temporal lift ,cheek lift , under-eye youth vaccines to fix the under-eye area

Pawel Szychta, MD, PhD, DSc · Answer

Hi.Based on the description of exposed fat pads and severe depressions, lower blepharoplasty may be a more effective option for significant and long-term improvement. It directly addresses structural issues such as excess fat and volume loss in a way that Morpheus8, a non-invasive treatment, may not be able to do.
If your main concerns are structural (protruding fat pads and collapsed muscles), surgery will provide faster and more comprehensive results.If you are hesitant about surgery and are primarily concerned about mild skin sagging or texture issues, Morpheus8 may help tighten the skin, but will not significantly address fat redistribution or volume loss.

Lower blepharoplasty or RF Microneedling for exposed pad & severe hollows under eye? (Photos)

Answers (12)

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