What Are the Risks and Long Term Results of a Blepharoplasty with Fat Repositioning?

I'm considering a transconjunctival bleph with fat repositioning (arcus marginalis release), but I've read that this is a risky procedure(has more potential complications) compared to a standard bleph where fat is taken out. And what are the long term results?As the fat is only repositioned and not removed isn't there the risk to form EYEBAGS again after a few years?Does the repositioned orbital fat on the surface of the cheek bone stay there forever or can it move back to its original position?

Doctor Answers 5

Achieving A Youthful Appearance in The Orbital Area

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Current techniques in lower eyelids blepharoplasty has certainly changed over the years as we have gotten a better understanding about aging and how to correct the signs of aging around the eyes.    The repositioning of fat into the tear trough zone of the lower eyelid is a very useful technique in filling this age related groove.  This can be accomplished via the transconjunctival approach as well as an external subcillary incision.  I generally find most patients will do better with the external approach as there is more precise layering of the orbital fat into the tear trough groove and the external approach allows us to tighten the orbicularis muscle and elevate the cheek fat to fill in the lateral orbital rim.  All of these techniques help to soften the area around the eye and give this are a more youthful appearance.  

Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Blepharoplasty Side Effects/Risk

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Thank you for your question. 

Fortunately, significant complications from aesthetic eyelid surgery are infrequent. Every year, many thousands of people undergo eyelid surgery successfully, without experiencing any major problem.

The risks in most surgeries are similar. Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection, and changes in sensation, scarring, allergic reactions, and damage to underlying structures. The need for revisions or unsatisfactory results may possibly necessitate additional procedures and may include medical risks. Following the surgery, there can be a feeling of dryness or irritation in the eye that requires treatment. There is a possibility of impaired eyelid function that sometimes may need to be corrected by additional surgery.

You can help minimize certain risks by following the advice and instructions you are provided both before and after your eyelid surgery. Best of luck!

Dhaval M. Patel 

Double Board Certified 

Plastic Surgeon 

Hoffman Estates 




Dhaval M. Patel, MD
Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 100 reviews

Fat Repositioning for Lower Eyelid Surgery

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   Fat repositioning in lower eyelid surgery should not pose any greater complication profile than lower eyelid surgery with fat removal.  The transposed fat can be sutured to keep it in position.  Another variant on that is to remove fat from the lower eyelid and fat grafting to the tear trough.  Most people need both fat removal from the lower eyelid and fat addition at the tear trough by whatever technique preferred by the surgeon.  Find the plastic surgeon with best credentials.

Risks & long term results of bleph with fat repositioning

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Repositioning of fat has only been around a few years so there aren’t any long term results.  The question is whether or not fat will remain viable outside of the open pocket over time.  A typical transconjunctival lower blepharoplasty is usually good for 10-15 years after the surgery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Risk of lower bleph with fat repositioning.

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The risk of fat repositioning should not be more than other types of blepharoplasty. In fact, this is becoming the standard method as the older fat excision only procedure left the eye looking sunken or hollowed which actually makes one look older.

Results should last many years and likely will not return to the full extent that they are currently. Seek consultation from a surgeon who has much experience in eyelid rejuvenation. Ask them how many they have done and how often will give you a good indication.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 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.