Q: Dr. Eppley, I am 29 and I had received 8 laser sessions under eyes for dark circles in which 2 were on full face. The skin subsequently turned saggy and became fatless under eyes and temple area. I waited 9 months but the skin did not improve. In fact, it became worse with time. I gone through two sessions of fat grafting now in the last six months, of which the last one was two months ago. My skin quality improved somewhat. In my case, little fat actually stayed and most of the grafted fat got reabsorbed. I have learnt with time I have to go through one or two more sessions to get better skin. Each time I was given about 10 to 15cc of fat under and near eye area. I did gentle massage after fat grafting to avoid lumps. But I now know that I will need a total of three or more grafting sessions to get a satisfactory result.
A: This is not the first time I have been told of someone receiving IPL (not laser) treatments with a large number of treatment sessions who subsequently had fat atrophy over the treated areas. The only restorative therapy for this facial fat loss problem is fat grafting as it provides autologous tissue and cells. But your story also shows that fat grafting is far from a perfect treatment as it can have very unpredictable survival. One has to be prepared to undergo multiple fat grafting sessions if needed, spaced about three or six months apart depending upon the response seen.
Dr. Barry Eppley