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For repair of aggressive lower-lid blepharoplasty, is fat transfer best?

Q:

My surgeon excavated too much fat from my lower lids and I now have hollow pockets that need to be filled. Is fat transfer best or should I pursue injectables?

A:

Removal of fat from the lower (as well as the upper) eyelids is an all too common occurrence. The best treatment for this is injection of fat in the area. Use of fillers can also correct the problem, but they are not permanent.

A:

I'm sorry you have had this experience.  I regularly perform structural fat grating on people who have had an overly aggressive blepharoplasy.  Fat grafting requires specialized tools, in additional to extensive training, expertise and patience on the part of the plastic surgeon. Be sure to find a plastic surgeon experienced with fat grafting and blepharoplasty correction.  The first step should be viewing many, many fat grafting before and after photos. 

A:

I am sorry that you are having this problem.

Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: temporary fillers, conservatively performed longer lasting micro-fat grafts, secondary blepharoplasties, and combinations of the procedures. There is no one best procedure. Each has benefits and drawbacks and depends on desired outcome and individual anatomy. Following the advice of anyone who would presume to tell you what to do without seeing photos and without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person. Robert Singer, MD FACS La Jolla, California

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