Bleph + Fat Transfer After Hyaluronidase Damage

3 MONTH UPDATE (FINAL UPDATE!)
Unless there are any further dramatic cases, this will be my last update on RealSelf, but PLEASE feel free to DM me as I know how stressful this process can be.
I’m still absolutely thrilled with the outcome! I'd say about 40% of my fat remains (maybe 30%??) and, along with the bleph, that has provided me with the improvement I needed to feel satisfied with addressing the hyaluronidaise damage and regaining my face structure.
I’ve definitely had some up/down days with some signs of my eye bags/malar creases returning, particularly around the holiday period. Think there was some swelling/water retention in my under eye area that came from factors such as diet, lifestyle and sunburn, as well as some of the fat settling.
I freaked out a bit as I didn’t feel great about the fact that I had spent so much money on my surgery. However, returning back to ‘regular’ diet, along with some face massage and exercises, saw them mostly fade and again, I’m thrilled with the outcome. For transparency, I've provided a photo of what this looked like on one of the worst days, but keep in mind this was in the WORST lighting and resolved itself fairly quickly! Of course, they’ll always be there in some form, but I just need to compare them to what they were like before to feel better about them.
For those of you considering surgery for under eye bags/hyaluronidaise damage here are my final pieces of advice to deal with the physical, emotional and mental aspects:
- Find a surgeon whose artistic eye and perception of beautification aligns with yours. Beauty and surgical improvement are SUCH a subjective processes and the surgeon is going to have to make decisions that you’ll just need to trust them with. Some surgeons have a style that is more of a dramatic improvement instagram-modellike makeover. Others are more conservative and focused on making you look like a refreshed and rested version of yourself. Different people want different outcomes and so it’s important that you judge each surgeon's prior work with this lens, not just talk about it with them. Would you realistically be comfortably walking outside with a face that dramatically different? Would you be disappointed if the improvement was so conservative that no one would ever pick up on it? You'll need to decide this for yourself then previous work is the best evidence of how they will approach your face!
- No question is a dumb question when it comes to consulting with your surgeon. Write your questions down ahead of your consultations so that you don’t get overwhelmed and forget to ask. I thought back to these consults so many times during the pre-surgery and healing phases!!
- Create an album of photos from your ‘before’ where your issues and flaws you're seeking to address are really obvious. I found this really helpful during the healing process, especially when I had moments of thinking “why didn’t the surgeon get rid of this?” I just had to look at those photos to see that it was already an 80-90% improvement on my ‘before’. It’s easy to get used to our new and improved looks and become unsatisfied quickly!!
- Organise your work/life/social life so that you don’t have to see people for at least 2-3 weeks out from the date. I thought I’d be ready at 10-14 days and, looking back, it was still quite obvious I’d had something done at that point, particularly with the extra volume of the fat transfer. This made me pretty stressed and self-conscious.
- Don’t judge your results until at least 8 weeks out, and even then, your swelling will continue to go up/down, so realistically this should really be the 3 month point. The healing process is not linear and it is likely you’ll have days where you FREAK out over what you think is the surgeon going too far or not going far enough. It's also easy to get used to the volume at earlier stages in the process when swelling is still present, and then be disappointed as the fat/swelling settles, whilst still having a major improvement (I've seen this in a lot of other fat transfer reviews, and I understand!) but no point judging your results before this. That’s just extra, unnecessary stress!
- I’ve spoken on this in previous posts, but again, make sure that you work on your self esteem and detaching from the outcome well before you go for surgery.
- I've also spoken on this in previous posts, but I do think it's best to combine fat transfer with another procedure, because of cost vs outcome (it's a conservative outcome).
That's all from me, but please do DM me if you want to know more.
I'm so glad I did this!!! Would 100% recommend my surgeon for those wanting to address their issues and get a natural result.

So I am about 10 weeks out now and I’m still thrilled with the results. I now take lots of pictures of my face haha. It has actually improved my face shape, with more volume in my upper cheeks and more of a heart shaped face than a rectangle!!
The short review is that I'm so glad I went through with it and I'm so impressed by the skills and aesthetic eye of my doctor :)
In the interests of being fully transparent and sharing as much detail as possible, here is the more detailed review:
The healing process has not been linear, with some swelling and tenderness still popping up a few days here and there, and the bleph stitch sites next to my eyes still a tiny bit red on some days, particularly after exercise, but overall the healing process has been fine and the result is definitely stablizing at this point.
I’m really glad I did the COMBINED procedures of fat transfer and bleph. Maybe I would’ve been happy with bleph alone, but I do believe it’s best to combine fat transfer with another procedure.
Why?
For me, around 30-40% remains of my fat transfer.
Personally, this has given me a wonderful outcome and improved my hollows, particularly next to my nose, which was COMPLETELY deflated prior to the transfer, but which is now volumised :D The transfer has now leftme with a refreshed and youthful looking face. However, because of the conservative results, I do understand the RS reviewers who found fat transfer to be less impactful than they expected.
The hard truth is that fat transfer, done by a good doctor, is going to deliver a conservative result rather than a dramatic one, as it's much better to end up under filled than over filled and go back for a second fat transfer to top up.
So yep - I do feel that fat transfer done alone would probably be quite an expensive/invasive procedure, unless you find a doctor who will do it under local anaesthesia. In my case fat transfer alone was going to be about 5.5K USD, compared with bleph + fat transfer for about 7K USD.
For this reason, I believe it makes SO much more sense to combine fat transfer with something else - a bleph, lip lift…anything else! OR to do it under local anaesthesia as a more minimal/less expensive procedure. However, my doctor believes that local anaesthesia reduces the risk of fat surviving, so does it under general only. I’m so happy with his work that I’d only go back to him, so if I do decide to do a second round I’m going to wait until I need something else done in a few years.
Other parts of my procedure that aren't "perfect". There is still SLIGHT bulging underneath one eye. Prior to the procedure my doctor suggested to not completely remove the fat pads as having complete hollowness is just as bad as having a bulging fat pad. The bulge now is a fraction of what it used to be. I still notice it, but when I compare it to what it used to be, it's still like a 80% improvement!
Also, while I had swelling my malar creases were completely gone. Now the swelling has subsided they are still visible in SOME light (and not everyday like they used to be).
Other things I’d like to share:
- I strongly recommend you take stock of all the aspects of your face that your procedure WON'T change, so that you have a realistic expectation of the results. Before my procedure my doctor kept reminding me that these procedures won't change the 'blueprint' of my face i.e. some of the asymmetries will still be there. He was also pretty honest about the fact that it probably wouldn't impact the lower part of my face (I was hoping it would give it a bit of a lift!) Without discussing this, I think it would be easy to get fixated on those things.
- I STRONGLY emphasize that you should work on your mental health/self esteem BEFORE doing a cosmetic procedure. If you don’t , going through cosmetic surgery will be hell for you. There is so much anxiety induced through the process of recovery, because there is always the chance that things could be botched and you will have so many up/down days. So I do think you have to get to a point where you could live with yourself regardless of your appearance or honestly, it would be a really stressful experience. I spent 1-year working on my mental health and changing my mindset and perspective around my appearance and learning to be happy regardless of the damage or outcome of the surgery and that is the only reason I felt okay with going ahead with the risks.
, I can really see how people end up on a never-ending spiral of cosmetic surgery procedures because, unless you work on letting go of your attachment to your appearance, you’ll ALWAYS find something to fix. Just look at someone like Bella Hadid who has perfect facial features, but still continues to use Facetune and photoshop her photos. Without working on your self esteem there is no ‘end point’ to cosmetic improvement. I notice myself now sometimes fixating on my lip shape, neck etc. when these things have never bother me before. The reality is that in the end we all age and looks don’t last!
Cosmetic surgery might minimise your anxieties around some aspects of your appearance, but it will not change your mindset, your relationships or your insecurities! Only you can do that!
Please feel free to ask questions :) I’m very happy to share

(for some reason, photo didn't upload with last post)

Here's a little look at the stitches next to my eye from the 'pinch' bleph. So tiny and still healing.

Some people have also asked about eye shape changing with the bleph. I'd say that mine did maybe a tiny bit. During healing it was quite different (very round) but that's mostly resolved now. However, if you're concerned about this, this is definitely something to discuss with your doctor.