Lower bleph and fat transfer gone wrong: groove running down my face. (Photos)

Question

My doctor has agreed to redo the bleph and fat transfer, but I don't understand what went wrong. How did I end up with the groove running down my face? First pictures are before, and my face did not have the "fault line" running down it.

Mehryar (Ray) Taban, MD, FACS · Answer

You likely have combination of injected and eye fat causing the fullness you are seeing. I have treated patients just like yourself. Proper eye evaluation is necessary. Revision lower blepharoplasty using transconjunctival approach is reasonable to consider.

Armand V. Simone, MD · Answer

There are several issues regarding your presentation ----
1 -how long has it been since you have had the surgery --if it is fairly recent, swelling can be normal finding which takes time to resolve ... there is a big difference between 4 weeks and 4 months in the post op appearance. Does the same situation occur on the opposite side? 
2. there is some consideration with what was done with the lower lid fat ---removed or transposed.
3.  there is a suggestion of a groove high up in your pre-op photos which is called the nasojugal groove which predisposes you to a depression.  Fat placed above this line will make the groove look relatively more acute.  This may have also been accentuated with fat placed along the "cheekbone" which looks fuller and rounder.
4. be careful not to do anything too soon... Normally, patients will resorb a certain amount  of fat grafts, sometimes as much as 50%....If your surgery has been recent, i would wait 5-6 months before an additional intervention..  
5. You may want to ask your surgeon to fill out the groove with some hyaluronic acid [such as Restylane Lift] which will fill out and blend the groove a little better and also  buy some time till you see what will happen with the fat.... 
Good Luck,
Armand Simone, MD   FACS
Board Certified Plastic Surgeon,  New York, NY

Lower bleph and fat transfer gone wrong: groove running down my face. (Photos)

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Lower bleph and fat transfer gone wrong: groove running down my face. (Photos)

Answers (2)

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