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Hollowing after transconjunctival blepharoplasty – options for correction? (Photos)

I underwent a transconjunctival lower blepharoplasty combined with fat grafting to the tear trough and medial cheek during the same procedure. I did not have much orbital fat to begin with, so fat repositioning was not performed, but fat was removed from all three lower-lid fat compartments. After surgery, both lower eyelids appear more hollow and darker than before, while the tear trough area feels over-volumized, especially on the left side. The left lower eyelid is significantly more hollow and is my main concern. There is a visible depression directly below the lash line extending toward the lid–cheek junction. Both eyes also appear rounder than before, which I suspect may be related to loss of lateral fat and structural support. The hollowing becomes more noticeable when I smile, with a visible indentation in the upper part of the lower eyelid. My questions are: • Is fat grafting possible in the upper lower-eyelid / preseptal area to restore volume? • Can loss of lateral fat and its structural support be restored with fat grafting, or would other procedures be needed? • In cases like this, can septal advancement or other support procedures help? • What are realistic options when too much fat seems to have been removed in a patient who already had a hollow eye anatomy?

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