Why Fat Grafting Under Eyes is Not Advised, and Alternatives for Volume Enhancement

Описание: A 37-year-old Caucasian woman wants to know the pros and cons between fat grafting and blepharoplasty.

Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, observed that this woman has relatively prominent eyes, puffiness, and hollowness below the eyes. The key to the best plan is identifying what affects her appearance the most. He says it is always tempting to have multiple procedures at one time, but he strongly believes in minimal trauma and getting the goals clearly defined. Different doctors will have different perceptions about a patient’s case. He had a number of patients who had procedures done by another doctor, but were disappointed with their result because their expectations were not met.

Dr. Prasad says that fat grafts placed in the lower eyelid area is unpredictable. Although theoretically or technically it makes sense to try to restore fat in the lower eyelid area, little bumps and irregularities are common in fat grafting. About 30-70% of grafted fat can be absorbed by the body. In addition, the lower eyelid skin is so thin that it easily shows all irregularities. He has had patients from all over the world with fat grafts who wanted him to remove the lumps. He had to get to the grafts through different planes of the eyelid in order to reduce the irregularities, which often results in potential destabilization of the eyelid structure that requires more than one surgery. Fat grafts placed in the cheek area, nasolabial folds and in other areas except the lower eyelid is acceptable as those areas have thicker skin so will not show irregularities.

If the face is relatively hollow like this woman’s, Dr. Prasad suggests a facelift, volume augmentation in the cheek area or placement of submalar or cheek implants. There are many options to explore when dealing with the lower eyelid puffiness. A limited blepharoplasty such as a transconjunctival blepharoplasty with some reduction of that fat may be helpful for her.

Dr. Prasad says that if she is going to choose fat grafting, she should have it done in the lower face rather than the lower eyelid. There are also alternatives to fat grafting on the face such as the placement of submalar implants to add volume in this area. She should think about her priorities, find a doctor that she resonates with and take smaller steps. She should also be more conservative in the beginning before moves forward with a more extensive procedure.

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