Hollow upper eyelids at a young age, should I do fat injections?

Question

31 years old, upper eyelids that has gotten more and more hollow over the last 5 years making me look tired/sick. Miss the way I used to look a few years back (see attached photo with white tee). Suggestions- fat injections or fillers? I’m afraid the surgeons in my area take it too «lightly» as they said it would take 40 min (including consultation), while online I read it’s a very difficult procedure. (Has seen an eye specialist ect.- no muscle weakness etc. Mom has the same issue).

Jason Emer, MD · Answer

I HATE fat to this area but do love fillers like belotero, restylane refyne, versa, or juvederm volbella.  please see an expert though as. this is a high risk area.  Best, Dr. Emeer.

Ali Riza Öreroglu, MD · Answer

Fillers and fat grafting both can be options. It is recommended to consult a board certified facial plastic surgeon in person and discuss your goals and options after a physical examination along with a mutual conversation and then make the decision to have the operation.Hope this helps,Ali Rıza Öreroğlu, MD FEBOPRASEuropean and Turkish Board Certified Aesthetic, Plastic and Reconstructive SurgeonIstanbul, Turkey

Michael P. Morrissette, DDS, FACS · Answer

Both are acceptable and you should get an excellent result with an experienced injector. Personally, I have used both and  prefer the results with fat grafting. The fat grafting procedure is performed with intravenous anesthesia so it is more invasive. The results are completely natural as your body will accept the transfer of the fat with negligible swelling. The lid-cheek junction can be made more youthful and convex and some of the fat that is transferred with not resorb. As you know, all HA fillers resorb. Lastly, the results with fat grafting leave the skin with a healthy and shiny appearance.

Mehryar (Ray) Taban, MD, FACS · Answer

The 2 options are fat injection and filler injection. Each has pros and cons. In general, filler is more precise and more predictable. See an expert.

Leonard Grossman, MD · Answer

I think you're absolutely correct in the fact that fat grafting would work the best for you. The procedure is not 40 minutes long and should never be done at the same time as your consultation. It is a surgical procedure that needs to be scheduled in advance, your desires and options should be discussed in detail with you showing on your own photographs what it is you would like to achieve. The plastic surgeon should also tell you if he or she can or cannot achieve the desired result. It also appears that your lower eyelids and cheeks should be augmented with fat as well as this will produce the best and most natural results, as long as the procedure is done by a plastic surgeon with a lot of experience in fat grafting. I hope this helps and good luck from New York City plastic surgery

Shaun Patel, MD · Answer

This is an area that can be treated by an experienced injector using a filler like Restylane. I find filler gives a predictable result in this area. I perform the treatment using a microcannula to enhance safety. This is an advanced injection that required an experienced injector.

Robert T. Buchanan, MD (retired) · Answer

You are right about the time to consult and do a procedure for this. It is a very complex procedure with significant risks and requires excellent knowledge of the anatomy. It takes me most of that time just to evaluate someone properly and explain the procedure. Either a filler with minimal water absorption like Juvederm Volbella or Vollure or fat grafting work very well. You have to know how to do the fat grafting, however to make it work. You do, however, frequently have to graft twice to get maximum fill because there is very little space and you cannot add very much to the area without reducing the blood supply to the area and, thus, the grafts. The most I have had to do is twice, however, since I get 75-80% take of what I place. If you have to, go elsewhere. Good luck.

Hollow upper eyelids at a young age, should I do fat injections?

Answers (7)

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