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Orbital Fat Grafting
for Upper Eyelid Hollowness
from Multiple Causes

Before and After

Photos depict actual patients of Dr. Meronk. While typical, results shown may not be obtainable in all cases since every patient's outcome will be influenced by a range of variables. Display of patient photographs does not constitute a warranty or prediction of outcome.

Advanced upper eye hollowness after blepharoplasty

Before orbital fat grafting
upper orbital fat 18 months
18 months after

Left Eye - Before Left Eye - After
Hollowness gone; brows higher and better inflated

View this patient's progress during healing

View closeup photos of other eye

Spontaneous hollowness in the mid-twenties
(no previous surgery)

Snapshot taken ten years earlier

Right eye: flat platform lacking crease (doll's eye)
Left eye: doubled high crease

Small-incision upper orbital pearl fat grafting

Progressive one-sided hollowing many years after tumor surgery

Before orbital fat graft After first graft After second graft
Before After second graft
six years after orbital fat grafting
Six years after orbital fat grafting

Hollowness after ill-advised upper blepharoplasty
on a patient in her early twenties


(1) Snapshot taken several months before blepharoplasty

(2) Two years after upper eyelid surgery
High, rounded creases have stripped away youthful identity shown above

(3) Same patient under less direct illumination
Fat loss has exposed the orbital bone contours. Eyes look and feel tired.


Nine months after orbital fat grafting
Restoration of volume above incision

two and one-half years after ofg
Same patient, 2 1/2 years after orbital fat grafting

Deep upper hollowness developing after viral infection


One year after upper orbital fat grafting x 2

Before (same patient, looking down)

Volume stable one year after

Harsh appearance many years after upper & lower blepharoplasty

before orbital fat restoration
upper orbital fat 18 months
After small-incision upper orbital fat grafting:
creases softened, skin redraped, and orbital bone de-skeletonized

right eye before
Right Eye - Before Right Eye - After
left eye before left eye after
Left Eye - Before Left Eye - After
As is sometimes the case, volume restoration on only the upper lids
may slightly improve on lower lid hollowness/retraction as well.

eye down before
Downgaze Before - Upper Concavity
eye down after
Downgaze After - Volume Restored

Upper hollowness and eyelid distortion
after brow lift alone (no blepharoplasty)

upper hollowness before
upper hollowenss after
Eight months after small-incision orbital pearl fat grafting

Hollowness developing shortly after non-invasive
nitrogen plasma skin regeneration treatment by
dermatologist to fade brown spots on upper eyelids

After orbital fat grafting

Right Eye - Before Right Eye - After

Extreme upper and lower eye hollowness
after blepharoplasty and aging


Orbits are almost devoid of fat with
eyes sunken inside empty sockets.

After upper (x2) and lower (x1) orbital fat grafting over the course of one year

In addtion to eyelid and brow improvement,
the eyes are now more normally positioned in the socket
(preexisting right ptosis remains).

(Shown six months after final procedure)

Doll's Eye Deformity after blepharoplasty and brow lift

After orbital fat grafting for upper and lower hollowness

Skin and fat shortage after upper blepharoplasty

before ofg
Before - Unnaturally stark creases and retracted upper lids in a
young man with a previously heavy-lidded masculine appearance.
He no longer resembled himself or anyone else in his family
and had to squint his eyes to blink.
after ofg
One year after both upper orbital fat grafting and full-thickness skin grafting
(in essence, a "reverse blepharoplasty")
ofg downgaze
In down gaze, added volume from the fat graft is visible between
the brow and crease. Lighter tissue near the lashes is the skin graft,
which takes several years to fade to its fullest extent.

Multiple skin folds and hollowing (no previous surgery)

asian upper hollowness
Multiple skin folding with extreme crese height and depth on right side
asian after orbital fat grafting
One year after orbital fat grafting

Multiple skin folds and brow descent after upper blepharoplasty

Redundant folding due to deflation after fat removal, and
descent of the brows due to inadequate support from below.
one year after upper fat grafting
One year after upper orbital pearl fat grafting.
Lids reinflated and brows noticeably elevated.

Upper and lower hollowness after blepharoplasty
before orbital fat grafting

Following upper and lower blepharoplasty one year earlier,
volume depletion left the eyes and face looking older and less expressive.

after upper and lower hollowness repair
After Upper and Lower Orbital Fat Grafting
(postoperative photo courtesy of patient)

Hollowness after upper lid surgery in a young Asian woman

Before - Hollowness in the Asian upper eyelid
is often manifested by multiple creases and folds
Three months after orbital fat grafting and internal fat repositioning

Upper eye hollowness after blepharoplasty

Ten months after

Inherited severe hollowness in young man

Before Four Months After
(postoperative photo provided by patient)

Loss of volume long after eye socket fracture

Before Four Days After Fat Grafting
Note the interaction between orbital volume and brow position

Right upper eyelid age-related spontaneous fat loss

Before After

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