Through Bad Surgery I Have Hollowed out Areas Under my Eye - Fat Transfer an Option? If So, Where? (photo)

I had upper/lower eyelid surgery Oct 2010. My eyes feel awful and look awful. I've gone for second opinions and most say they've seen worse - learn to live with it. That perhaps may be true, however, the quality of my life has been affected. As I went in for a "rejuvenation" procedure, living with this destructive outcome sends me into despair. I'm considering fat transfer, as there is under my left eye a hollowed out area. I'd like to know what your panel of doctors might suggest. Thank you.

Doctor Answers 9


Thank you for your question. From my experience with your kind of situation the general issue is not necessary of just hollowing but rather the shape and contour of the lower eye lid. Although for many people the appearance of your lower eye lift would be considered an acceptable result after eye lift surgery. My own sense is that I would prefer that your lower eyelid where in a higher position and the shape of your eyes natural more almond shape. Would that understanding I would recommend considering lower eyelid surgery to correct the shape of the eye rather than adding fat volume under the eyes. Although you can have fat transfer to the areas under the eye I generally  don’t recommend fat placement in the eye lid skin rather I would place the fat in the cheek area to create volume that support the appearance of the lower eyelid. In general when I perform correction for lower eyelid retraction or hallowing under the eyes, the shape of the eyelids once restored, No longer is a satisfactory enough and most people not consider having very much additional procedures done to enhance the volume directly under the eyes.

New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Reconstructive vs Cosmetic

From a cosmetic standpoint, you would benefit from a browlift and a conservative eyelid ptosis repair [left greater than right].

From a reconstructive standpoint, you have lower lid retraction and canthal dystopia which could be addressed surgically with retraction repair [with internal graft] and canthoplasty.

I would address the lower eyelid hollowing [fillers or fat grafting] as a last stage, a few months after the other surgeries have been done.

If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.


A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Blepharoplasty revision

It would have been helpful to answer your post if you had also posted a picture from before the surgery as your complaints seem out of proportion to the findings on the photo. Although there is room for improvement through revision surgery the results are not so bad that they would be considered a "destructive outcome" by most surgeons. I think the less you have done the better off you will be. You could go the full course with canthopexies, fillers etc. but in your case only some filler like Juvederm to the hollow area on the left is probably the best solution.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Fat grafting around eyes

Without seeing preoperative photos it is difficult to tell what distructive problems you are describing  around your eyes.  The area under your left eye likely could be corrected with a filler.  I would start with a nonpermanent filler such as Juvederm or Restalane to see if it corrected the problem of concern prior to having a fat transfer,  even though the fat transfer may be the best option long term it is not without risk.  Having a consultation with a surgeon certified by the american board of plastic surgery would be helpful in evaluating all of your concerns in the periorbital area.

Jeffrey Thaxton, MD
Charleston Plastic Surgeon
4.2 out of 5 stars 6 reviews

Treatment of hollowed eye

Thank you for the question and the photo. I think what you need is a consultation with a plastic surgeon. You have to decide what are your hopes and desires. After that the surgeon can decide on the treatment options. Many people talk about fat injection as the treatment for every facial problem, but fat injection has it own problems and not sure if it is the right answer to your problem. 

When I look at your photo I see brow ptosis, cheek ptosis and you may may benefit from other procedures. I wish you all the best.

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Agree that this is a very mediocre blepharoplasty result.

There is over excision of the upper eyelid folds. There is left upper eyelid ptosis and your forehead (brow position) has fallen as a result of the upper blepharoplasty. There is a compensatory muscular hypertrophy in the glabellar area that makes you look cross. The lateral canthal insertion of the outer corner of the right eyelids has been pulled down by the transcutaneous lower eyelid surgery. Both lower eyelid margins are outwardly rotated as a resut of surgery making the llightly colored edge of the eyelid visible. Both lower eyelids look irregular and, yes, deplete of volume. What is the best way to address these issue? It depends on your budget and motivation. I would be very careful of simple fixes like fat grafting. Frankly I do not believe that anyone has sufficient control of the grafted fat to do this in a satisfactory fashion. I think you would benefit from a combination of surgery and fillers. This opinion does not constitute medical relationship or the practice of mediicine. You would benefit from a personal consultation.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Fat grafting to power eyelids

You can try an injectable filler like Restylane to see if you like the appearance for about six months before undergoing fat grafting to the lower eyelids.  Fat grafting would be an alternative.  you should discuss your concerns with your board certified plastic surgeon to determine what approach would be best for you. 

Todd C. Case, MD
Tucson Plastic Surgeon
4.9 out of 5 stars 55 reviews

Hollow Eyes

There are many ways to improve your hollow eye-orbital syndrome.  Fillers and Fat are but a few ideas that might help you.  Please consult a Cosmetic Surgeon who is a Diplomate of the American Board of Cosmetic Surgery (ABCS).  Also, check the ABCS website.  Visit a surgeon who is Board Certified by the American Board of Facial Plastic & Reconstructive Surgery (ABFPRS).

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews


You need to be more specific as to what bothers you exactly. Your eyes are tottaly different with different problems. I do not believe that just fillers or fat transfer to the lower lids is not going to solve all the problems. Make a list of what you want corrected and what bothers you. Cosult a board certified plastic Surgeon to discuss your personal concerns.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 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.