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FAT GRAFTING for hollow (sunken) eyes and
revisional blepharoplasty (cosmetic eyelid surgery).
One of the most significant advances in cosmetic EYELID
SURGERY, OR ANY cosmetic facial surgery over the last 5
years, has been the refinement of the fat grafting
technique. ONE EXAMPLE WOULD BE AUGMENTING BLEPHAROPLASTY
(or any cosmetic eyelid surgery) WITH SOME DEGREE OF FAT
GRAFTING.
Various types of facial fillers (Collagen, Restylane,
Juvederm, etc) have been used with great success over the
last decade. The primary purpose of these techniques has
been to treat wrinkles. We now know that in addition to
treating wrinkles, these materials can be used to add to or
augment facial volume. As our understanding of facial aging
has become clearer, we have come to understand that loss of
facial volume (fat, muscle and bone) is the primary factor
in looking aged. I call this process facial deflation. The
best analogy I can give is that in youth our face resembles
a grape and as we age it becomes more like a raison. This
change leads to hollowing, thinning, sagging, wrinkling and
a generalized skeletonized look.
WHAT CAN WE DO ABOUT EYELID HOLLOWING OR GENERAL FACIAL
HOLLOWING?
WHAT CAN YOU DO ABOUT SUNCKEN EYES OR PREVIOUS OVERDONE
SURGERY? We can fill the AREA THAT IS LACKING IN VOLUME (or
is hollow). The fillers mentioned above are just some of the
products available on the market today. There problem is
that they are temporary and can be pricey if continued use
is indicated (approximately $600 - $1000/every 4-6 months).
Fat grafting may be a better option. The technique involves
harvesting (taking) fat from donor sites in our body which
have excess (stomach, inner thighs, etc.) and transferring
the fat to areas on the face which are hollow (deflated),
SUCH AS LOWER EYELIDS. The added volume leads to a more
youthful appearance.
The fears people have about fat grafting is that the fat
will not take and that "lumps and bumps" or contour
irregularities may develop.
The success of fat grafting (survival of fat) depends on
many factors including harvesting technique, how fat is
prepared for injection (grafting), area of face to be
injected (FOR EXAMPLE, FAT GRAFTED TO LOWER EYELIDS TENDS TO
TAKE better than other areas of the face AS THERE IS LITTLE
MOVEMENT IN THAT AREA), condition of tissue to which fat is
injected, previous trauma, previous surgery, and injecting
technique. A good evaluation is critical in determining
these factors and how they will affect survival of the fat.
In the hands of an experienced surgeon, irregularities at
the fat injection sites are less common today then
previously. Today, fat grafting techniques are such that
this complication should be rare. If it does occur, it can
be treated with medications or, rarely, surgery.
I have found fat grafting to be an invaluable tool in my
practice which has augmented my surgical results
tremendously. This is especially true in revisional (redo)
blepahroplasty (cosmetic eyelid surgery) where eyes look
hollow (sunken). In addition fat grafting has been an
invaluable tool in primary (first time) blepharoplasty
(cosmetic eyelid surgery) where excessive removal of fat can
lead to hollow and sunken eyes.
Fat grafting is an excellent technique for the treatment of
facial hollows, eyelid hollows, the sunken look, overdone
previous surgery, and generalized facial ageing.
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