Is there a specific technique to inject fat in the upper eyelid?

I'm writing from Eastern Europe and would appreciate an advice as upper eyelid fat grafting is a very new procedure in my country. I expressed a wish to get a fat injection into my upper eyelids and asked the doctor specifically about the points on the eyelid where the fat is injected. she just said where is needed. she routinely does lower eyelid fat injections. my question is whether there is a specific technique to inject the fat? or the doctor doesn't know what she's talking about?thank you

Doctor Answers 5

Injecting fat into upper eyelid is a dangerous

Thank you for your question.  Injecting anything into the upper eyelid is very dangerous in my opinion.   A blind needle injection risks damaged to the Levator  muscle which controls movement of the upper eyelid.

If that is needed in the upper eyelid than it should be done through an open incision so that placement of the fat graft can be properly and accurately done without damage to the eyelid levator mechanism.

Fat injections into the upper "eyelid" is actually done up close to the bone.

When you say "eyelid" I assume that you have a deep hollow area above the eye, called the superior sulcus.  This hollowing may worsen with age, so that your eye area looks bony.  The fat is placed up in this area fairly close to the bone.  This is not an easy procedure, so you want to make sure you go to either an oculoplastic surgeon or facial plastic surgeon who has a lot of experience with fat grafting.

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 28 reviews

Fat transfer of the upper eyelids

in general your doctor is saying is true, you put it where it is needed.  However, there are some tissue planes or spaces that you want to avoid.  He don't want the fat directly under the skin or even directly underneath the orbicularis muscle of the upper eyelid.  In general the fat needs to be behind or deep to the septum and often against the roof of the orbital rim or the orbit itself.

My disclaimer is I have never seen you and I don't know your anatomy but in general these are the areas I placed fat in the upper eyelids.  Fat transfer to the upper eyelids in particular should be performed by very experienced surgeons who are comfortable with the idea of dealing with any complications that may arise such as lumpiness, asymmetry, or even the worst possible outcome which technically is blindness.

I would stick to oculoplastic surgeons or facial plastic surgeons who are experienced in eyelid and orbital surgery

Best of luck

Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 76 reviews

Injecting fat in the upper eyelid

As our face ages we often start to lose volume in our eye area first causing hollowing in the upper and lower part of our eyes. There is a special technique that facial plastic surgeons use to inject fat around the eye area since we are very careful to ensure that the area is smooth. It is always best to schedule a consultation with a facial plastic surgeon and be sure to bring your youthful pictures with you to the appointment so that you face can be evaluated for volume loss. By comparing your pictures your physician can show you where your volume loss is and where you will be injected. Wish you the best with your next consultation!

Kristin J. Tarbet MD, FACS
Bellevue Oculoplastic Surgeon
5.0 out of 5 stars 24 reviews

Fat injections in upper eyelids

There are indeed specific techniques and indications for fat grafting in the upper lid. Just as in other areas of the face and lower lid, fat loss and hollowing is the hallmark of facial aging. Fat grafting into the upper lid requires experience and specific training. Look for board certified specialists.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 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.