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BLEPHAROPLASTY 101

Augmentation Blepharoplasty
Fillers and Fat

orbital fat grafting for eyelid hollowness logo

Volume enhancement for
hollow and sunken eyelids

"Many obliging surgeons are unwittingly contributing to an epidemic of post-blepharoplasty hollowness."


Healing to 18 months after
upper orbital fat grafting




Grafting of structurally-intact fat seems to provide a durable effect analogous to that of a skin graft once it has established a new blood supply. Within days, the pearls adhere to one another and form a smooth layer in the precise deep anatomical space intended for normal orbital fat.

Healed grafted fat has appeared entirely healthy when viewed during the few secondary operations we have undertaken in severe cases for additional augmentation. In the patient shown here, there is little evidence of loss of grafted volume even after the first few days. Following resolution of swelling and bruising (which can vary from 4-12 weeks), the vast majority of results have been stable.

A slight right ptosis (droopy eyelid) was present for the first six months, after which it improved gradually and then finally disappeared between 12-18 months.

In the three patients in our series in whom the fat graft failed completely (two had already undergone mu tip le revision operations elsewhere; one had never had surgery), volume loss was noted almost immediately. It thus appears that grafted fat either quickly establishes a blood supply and becomes viable and stable or rapidly dies and is absorbed.

INTRODUCTION

Socket Fat and the "Orbital Flat Tire"
The importance of fat around the eye

The "Doll's Eye Deformity"
Advanced upper eyelid hollowness

PREVENTION

Preventable Causes
Acquired hollowness

AREAS OF HOLLOWING

Upper Eyelid Hollowness
A high and deep upper crease

Lower Eyelid Hollowness
The sunken lower eyelid

Upper Cheek Hollowness
Midface descent & the tear trough deformity

What is Meant By Under-Eye Hollows?
Why this term is best avoided

RESTORING VOLUME: OPTIONS

Fat Transfer Terminology
Why fat injection is not fat grafting

Enhancement Options Overview
What works, what doesn't

ORBITAL FAT GRAFTING

Pearl Fat Grafting
Particulate fat grafting for lower hollowness

Strip Fat Grafting
One-piece fat grafting for upper hollowness

Double Layer Strip Fat Technique
An operation for advanced upper hollowness

Combination Strip-Pearl Fat Technique
An operation for severe upper hollowness

Small Incision Approach
Upper fat grafting through a tiny incision

ORBITAL FAT REDISTRIBUTION

Orbit-to-Orbit Fat Transfer
Using excess fat to best advantage

Internal Orbital Fat Relocation
Redistributing fat within the orbit

PERIORBITAL FAT AUGMENTATION

Autologous Fat Transplantation
Fat injection around the eyelids

Synthetic and Non-Fat Biological Fillers
Fillers introduced by injection

Dermal Fat Grafting
Skin-fat graft for periorbital depressions

BEFORE AND AFTER PHOTOS

Before and After Photos - Lower Eyelids
Patients hollowed after blepharoplasty

Before and After Photos - Upper Eyelids
Patients hollowed naturally or after surgery

Sequential Healing Photos
Healing over 18 months


FREQUENTLY ASKED QUESTIONS

Orbital Fat Grafting Essentials
Questions and answers

RELATED TOPICS

Healing and Recovery
After orbital fat grafting

Eyelid Anatomy
A reference page

Brow Lift and the Hollowed Upper Eyelid
On undesirable interactions

Removal of Excess Grafted Fat
Addressing an overcorrection

Dark Circles Under The Eyes
Options for under eye discoloration

OTHER RESOURCES

Blepharoplasty 101
Full Table of Contents

Before and After Photos
View results of upper and lower eyelid surgery

Blepharoplasty Healing and Recovery
After upper and lower eyelid plastic surgery

blepharoplasty resource
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Frank Meronk, Jr., M.D.
All Rights Reserved

Disclaimer: Information, observations, and opinions are presented for general reference use only and do not constitute specific medical advice, diagnosis, or treatment. Base all decisions solely upon the recommendations of your own doctors. With each use of this website, you signify your review and full acceptance of our current Terms of Use.

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