Under eyes look horrible after lower blepharoplasty - would fat grafting or skin removal be an option? (Photo)

Question

I had lower blepharoplasty performed by an ocuplastic surgeon 8 months ago. After the swelling went down I noticed the skin was loose and my eyes looked hollow. I had filler 3 months ago via a highly recommended dermatologist but it seems to have migrated down a bit and my eyes are hollow again. The skin under my eyes and around my tear troughs/uppercheek bunches up a lot when I smile. I feel like I look like a very tired chipmunk. Would fat grafting or skin removal be an option?

Kenneth D. Steinsapir, MD · Answer

Yes, lower eyelids can be revised. What you might need cannot be determined with these obscured photographs. Not all fillers migrate. The best filler for the lower eyelid continues to be Restylane. However it takes tremendous skill and experience to perform this type of filler service. Using runny fillers in this area is a terrible mistake that compounds your concerns. I encourage you to consider carefully who you might see to be assessed for your concerns and learn what options exist to achieve your goals. Often this means that you will have to travel to get the care you need. Very few surgeons offer the type of reparative work that you will need.

Raffy Karamanoukian, MD, FACS · Answer

There is a distinct crease on the lower eyelid that may be corrected by attenuation of the lower orbicularis fibers along the orbital rim. I would combine this with mild fat transfer.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Under eyes look horrible after lower blepharoplasty - would fat grafting or skin removal be an option? (Photo)

Answers (2)