Restoring orbital fat pad after transconjunctival bleph - can this be fixed? (Photos)

Based on these photos it is my impression that your postoperative result is better than your before surgery photo! This is just a personal opinion. It is possible that further fat grafting would produce some volume improvement in the cheek/ lover eyelid area; small periorbital implant may be considered. Good luck.

Based on your nicely posted before and after photos, I see two possible options. First to do nano fat grafting under local anesthesia, possibly in two sessions 2 to 3 months apart each session $2500 plus. Option two is HA filler injections Bob Bella, for example, in multiple sessions Each session approximately $500-$1200. Best of virtual consult with to get better understanding.

The transition between the lower eyelid and midface is complex and inherently challenging.
Evidence of facial aging in this area is often attributed to a lack of volume in the upper midface concurrently with fullness in the lower eyelid fat pads.
There are opposing volume issues that are immediately adjacent to each other.
This is one reason why this area is so difficult to treat and results are potentially unpredictable.
It’s helpful to understand if the primary issue is bulging of the lower eyelid fat pads, or a loss of volume in the upper mid face.
Often it’s a combination of both.
The inherent Primary issue is often based on insufficient, skeletal structure creating a lack of support or foundation for the soft tissues.
Facial aesthetics are primarily determined by facial skeletal structure.
Those who will age well versus those who will not can be predicted based on skeletal structure.
Volume restoration of the upper midface can be accomplished by using fillers, fat transfer, implants or a midface lift.
Reducing fullness in the lower eyelid is usually done by removing fat pads, which you had done.
Whether volume enhancement of the mid face or volume removal of the eyelid is a better procedure depends on each individual person and providers will have different opinions as well.
Restoring the volume represented by the lower eyelid fat pads it’s not easy.
Fat cannot be grafted successfully in the same anatomic location. The lower eyelid, fat pads are deep to the periorbital septum.
The area is anatomically complex.
My best recommendation is to focus all your efforts on providers selection, which is usually the strongest correlation with quality outcomes.
Finding the right provider is much more difficult than most people realize.
Consider looking at the results of Dr. David Mabrie MD in San Francisco.
David is a facial plastic surgeon whose focus is exclusively on injecting fillers.
David does not do any surgery.
His results with volume enhancement using fillers is the best I’ve ever seen.
His results are in my opinion of the gold standard.
I’m not suggesting everybody flight to San Francisco to get fillers.
I do think that studying his results can be a powerful tool in understanding what can be accomplished using only fillers.
I’m not a big fan of fat transfer to this area.
The results tend to be unpredictable at best.
When interviewing surgeons ask them to open up their portfolio and show you their entire collection of before, and after pictures of previous patients had similar facial characteristics.
Do this for whatever procedure they recommend.
Bring pictures of yourself to use as a reference.
Learn, how do I identify quality results on patients who had similar facial characteristics.
Vetting plastic surgeons is not at all easy or straightforward.
I wish I had better options or recommendations for you.
For complex situations, I usually recommend patients rely exclusively on in person consultations.
Best,
Mats Hagstrom MD