Lower eyelid rejuvenation has undergone a tremendous evolution in the last decade. There has been a paradigm shift from fat excision to fat preservation. This has recreated youth rather than advancing the aging process which typically involves fat loss from the eyes and face.
There are two ways to augment volume (filling depressions with fat) in the lower lids. One technique is called fat repositioning. This involves translocating eyelid fat which is prominent to areas where it is deficient (depressions, grooves and hollow areas). This is an incisional surgical technique which I perform from the inside of the lid to prevent external scars. I have found this procedure to be reliable, reproducible and to consistently yield excellent results.
Below is an example of a patient who underwent lower lid blepharoplasty with fat repositioning (before – left/ and after – right). Note the reduction of lower lid “bags,” and filling of grooves underneath.
The other fat filling procedure is called fat grafting. In this instance fat is taken from a different area of the body (ex. abdomen) and injected (grafted) into the depressed areas around the lower lids. In experienced hands this also yields excellent results.
Below is another patient. She had fat grafting to the hollows at the junction of the lower lids and cheek. Note the significant improvement in appearance (before – left/ and after – right). Fat grafting does not require eyelid incisions but the results can be less predictable than fat repositioning.