Third Blepharoplasty or Fat Grafting for Hollow Eyelid?

I've had 2 Blepharoplasty surgeries, and the last one didn't correct the hollowness. I fear a 3rd surgery may affect muscle function and cause ptosis. Can surgery be done inside the eyelid (pink area), or a less invasive method of fat grafting to correct my results?

Can you refer a surgeon in Asia who can do this competently? I can't afford to go to U.S.

Doctor Answers 3

Fat injections will correct hollowness

Hollowness is the result of too much taken away. Replacement of fat is the only way to correct for this problem. I am not keen on other fillers around the eye area because they can get very lumpy and cause a bluish hue under the skin, making the hollow look worse even if it is improved.

New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

Transconjunctival blepharoplasty with fat grafting is possible

A third eyelid procedure is risky. Repeat external incisions can weaken the support of the lower eyelid and cause an ectropion or sad eyed look.

You need to be examined by an expert eyelid surgeon who can asses your lower eyelid support.

If you have good eyelid support and good eyelid closure then an operation on the inside portion of the eyelid, called a transconjunctival blepharoplasty may be possible. During this procedure, composite (whole) fat grafts can be harvested form the tummy and inserted into the lid to plump the dark circle.

Avoid filler injections or injection of fat through a needle, the risk of visible lumps, scarring and injury are too great, especially since you have had previous surgery.

I do not know of a surgeon in Asia who uses this technique.You will have to seek recommendations from your doctor.

See before and after photos of Fat Grafting.

Fillers are a good option

I suggest you try a temporary filler, such as Juvederm, into the hollow areas as a trial.

If you do not like the look it can be reversed with hyaluronidase, an enzyme, or it will go away over time. Hollowness is best corrected by a filler, rather than more excsion of skin, muscle, and fat.

Try not to get fat injection first, since it is not readily removed and it may or may not help you.

Good luck.

I do not have a recommendation in Asia.

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 18 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.