How do I fix my orbital fat loss, is a fat graft the way to go? (Photos)

Question

I have been using latisse for years and the result has made my eyes very hollow and old looking. Any suggestions on how to fix this? I heard a fat graft might be the way to go.

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  You could do fat grafting to that area, but you have to make sure you go to an experienced Board Certified Plastic Surgeon who has experience with fat injections in that area.  Fat can be too thick in that area if not done correctly.  I tend to like using Restylane in that area to help rebuild the collagen.  I find it is a nice smooth product that helps with the hollowing.  Restylane is only indicated to last about 6 months but as you keep up with it, it will last longer.  Best of luck to you.

Mats Hagstrom, MD (license on probation) · Answer

The change in your lower eyelids it’s probably not related to Latisse it’s simply a direct reflection of age.
The area is complex and treatment here is Afton misunderstood. Volume restoration needs to be done in an expert manner. If the volume is placed even slightly wrong the opposite effect can be the outcome.
Grafting fat is in precise, unpredictable and unforgiving.
Fillers on the other hand are the opposite. They are precise, predictable and highly forgiving.
Grafting tissue requires a numerous variables all being ideal and even then where and how much of the graft survives is still unpredictable. The fat doesn’t survive becomes firm lumps of necrotic fat with scar tissue.
In this particular area the underlying soft tissue layer gradually changes and that host tissue is what supports and keeps the graft alive.
In this particular area the underlying soft tissue layer gradually changes and that host tissue is what supports and keeps the graft alive. With very little host tissue graft survival becomes difficult with a higher incidence of fat necrosis.
Grafting fat is not like injecting fillers using your own bodies tissue.
I suggest having multiple in person consultations with local board-certified plastic surgeons to see what your options are. Treatments could include volume restoration and preferably using fillers, a lower eyelid blepharoplasty or Botox of your lower eyelid right at the lash line. your left lower eyelid forms a single line just below the lash line and that line may go away with a very careful and conservative use of Botox. Excessive use of Botox in the lower eyelid can create an ectropion perfect which is highly undesirable
It’s not an easy area to work on and I suggest being very selective when it comes to finding the right provider.
Look for senior plastic surgeons with years of experience and have proven track record.
Ask each provider to open up their portfolios and show you their entire collection of before and after pictures for whatever procedure they recommend.
Ask them to show you as many pictures as possible of previous patients who had very similar facial characteristics.
That’s the provider to show you examples of excellent outcomes, average child comes and outcomes it didn’t turn out as well as they had hoped for.
You can consult with plastic surgeons, facial plastic surgeons or oculoplastic surgeons.
In the end what matters is that someone has done a lot of quality work in the past and has the photographs to prove it.
Anytime you consider facial fat grafting do you need to know what the plan is if the outcome turns out differently than what you had anticipated. If you end up with lumpy fat necrosis I was not going to be managed? 
Ask providers specifically about revision rates and revision policy.
What you’re looking for it is not necessarily the correct procedure but rather the correct provider.
The situation or problem is complex and it’s not purely based on volume.
Best,
Mats Hagstrom MD

How do I fix my orbital fat loss, is a fat graft the way to go? (Photos)

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How do I fix my orbital fat loss, is a fat graft the way to go? (Photos)

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Our mission is to create a world where every investment in modern beauty is Worth It.