Risks of Fat Pad Removal on Lower Eyelids?

Dear Eyelid Surgery Patient from San Jose,
Removal fat pad from lower eyelid is done with a procedure called Transconjunctival approach. With this technique, incisions are made on the inside of the lower lid and fat is extracted. There are less chances of abnormal tearing or dry eye syndrome associated with transconjunctival approach in compare to traditional lower blepharoplasty. Although in some case with transconjunctival approach there are swelling in the area that cause temporary abnormal tearing.
 

Thank you for your question.  Dry eye can occur after lower Blepharoplasty.

The risk is greater when an external incision is made because the external incision can weaken lower eyelid support exposing more of the eye to air and dryness.

However transconjunctival lower Blepharoplasty is a more modern safer technique in which the incision is made inside the lower eyelid and leaves the eyelid support intact.

In my experience dry eye is very uncommon when this newer approach is used.

If you already have dry eye or decreased tear production your risk will be greater.

 

Dear Brown Spots,
2 questions in one.
1."When they remove the fat pads from the lower lids is there a risk to tear production?" - As was previously stated, any surgery on the eyelids COULD be associated with change to the tear film AND the way it drains across the eye. Lower lid surgery may be associated with a temporary dry eye which is controlled with eye drops.
2. "Risks of fat pad removal on lower eyelids?" Surgical complications are unlikely events that cannot be foreseen. Most are unlikely; some are VERY unlikely.
Removal of the fat pads of the lower lids can be done through a thru the skin (trans cutaneous) incision or through the smooth pink lining (transconjunctival) approach. The skin incision approach may be associated with the lower lid pulling down and white showing. Both approaches may be associated with damage to one of the muscles the move the eyeball resulting in double vision when looking down as well as the removal of too much fat, unveiling the rim of the eye socket giving an older Boris Karloff (look it up) appearance. Finally, there is a VERRRRRY small chance of blindness. (It has been reported - we all know about it - I never met a surgeon who has personally seen it).
Hope I did not scare you too much and that this was helpful.