Hollowing of the eyelids is a major problem for many patients presenting for eyelid rejuvenation today.  This can occur from aging alone, or also from previous eyelid surgery.  Contemporary thought is that fat around the eyelids is precious and must be preserved when possible.  In the areas of the lids which are prominent (puffy) where there is excess fat; the fat can be moved (repositioned) to areas of hollows or depressions.  It is important to remember that depressions and hollows around the eyes are as common and important to address as is fat prominence.  If this important point is not taken into consideration when performing eyelid surgery – patients will look skeletonized or sunken after the procedure.  This must be avoided.

The way to avoid this is to preserve local eyelid fat and move it around (fat repositioning), or to take fat from other areas of the body (ie. abdomen) and inject (graft) it into the hollows around the eyes.  Eyelid fat grafting is s very specialized and intricate procedure as eyelid anatomy is complex and the skin is thin. Only an expert in eyelid surgery should perform eyelid fat grafting.

Below is an example of lower lid fat grafting to correct hollows (depressions), improve contour, and restore a youthful appearance.  On the left is the before picture and on the right is the after surgery picture.  Note the improvement in lower lid appearance without an incisions (just fat injections).