Eyelid Pearl Fat Grafts
("Free Autogenous Particle Fat Transfer")

Fat tissue the size of small pearls (3-5 mm in diameter) may be harvested from distant donor sites (most typically from the fat around the belly button or beneath the pubic hair) and grafted into the eye socket to augment overlying areas of eyelid hollowness. Depending upon the severity of the volume deficiency, a variable quantity of pearls are implanted.

Several old reports indicated a survival rate of between 50-90% for pearl fat implanted just beneath the eyelid skin. Our experience with deep orbital implantation suggests a higher rate of take. While such older superficial methods often resulted in noticeable lumpiness, deep placement of orbital fat results in a much smoother fill.


Deep pearl fat placement into the orbit, while newer, appears to provide volume enhancement (or replacement following post-blepharoplasty hollowing) that is much more predictable while creating no external scar.

The pearl fat is grafted through a incision hidden made on the inside of the eyelid and into the natural anatomic compartment for orbital fat located just over the bone and behind the orbital septum.


Lower eyelid hollowness after blepharoplasty elsewhere
Before
Immediately After
(Surgery by Dr. Frank Meronk)

Orbital pearl fat graft initial "take" is significantly higher than with injected fat cells obtained by liposuction, most likely because of (1) much decreased trauma during fat harvesting, (2) the preservation of normal fat tissue "architecture" (normal connective tissue, blood vessels, nerves, etc.), and (3) placement of the graft into the normal anatomical location intended for orbital fat rather than beneath the eyelid skin or into the eyelid muscle where fat does not occur naturally. View healed orbital fat graft in place eight months after surgery

For treatment of upper eyelid hollowness, we employ a wider variety of approaches, some of which utilize pearl fat.

Lower orbital pearl fat graft before-and-after photos

Orbital pearl fat grafting in photos
Caution: Actual surgery photos

 Orbital fat grafting FAQs


Orbital Fat Grafting
Solutions for Eyelid Hollowness and Collapse



Overview
Socket Fat and the "Orbital Flat Tire"


Upper Eyelid Hollowness | Lower Eyelid Hollowness
Upper Cheek Hollowness | Preventable Causes

Treatment Options - An Introduction
Is Fat Injection the Same as Fat Grafting?

Pearl Fat Grafting | Strip Fat Grafting
Combination Strip-Pearl Fat Grafting Technique
Small Incision Approach

Lid-to-Lid Fat Transfer | Internal Fat Repositioning
Dermal Fat Grafts | Fat Injection | Dermal Fillers

Hollowness and Brow Lift | Doll's Eye Deformity
Hollowness in the Asian Upper Eyelid


Healing and Recovery

Removal of Excess Grafted Fat | Dark Circles
What is Meant By Under-Eye Hollows?
Pertinent Anatomy: Diagrams & Definitions


Orbital Fat Grafting FAQs

Surgery Photographed:
Lower Hollowness: Orbital Pearl Fat Grafting
Upper Hollowness: Orbital Strip Fat Grafting
Advanced Upper Hollowess: Combination Strip-Pearl Approach
Upper Hollowness: Internal Repositioning


That Tiny Roll of Upper Eyelid Skin (video)

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