Is Fat Grafting A Good Option For My Undereye Hollows?

Q: Dr. Eppley, I’ve been looking into treatment options for my sunken under-eyes—potentially fat grafting?

 A:Thank you for sending your pictures. You’re under eye hollowing, which primarily occurs along the infraorbital bony rim, can be treated buy a multitude of methods from fat injections to various implants placed along the bony rim. Each of these two fundamental approaches has their advantages and disadvantages. Injection fat grafting is by far the most commonly performed procedure for this problem and represents hey minimal invasive surgical procedure with little recovery. Its disadvantage is the unpredictability of How much fat survives and whether it will have a smooth contour. In other words irregularities or lumps and bumps are well-known to occur from fat grafting underneath the lower eyelid and upper mid face skin. The use of the implants to build out the informant to ram is a true surgical procedure and with that a more significant recovery of swelling and some bruising. There is a range of different implant options from tissue bank dermal grass to various forms of implants including custom-made implants. They have the advantage of adding a permanent volume with a much higher likelihood of being smooth throughout the augmented area.

The debate, of course is which one is better and that depends on both the patient’s anatomy and the patient’s preferences. The ethnicity of your facial bone structure is such that you have a flatter midface projection and, as a result, would be better served long term with a more assured permanent augmentation approach. The debate then becomes what type of material is best to use. From my experience this comes down to whether the patient wants to use something off-the-shelf or whether one wants to use a custom implant approach. That would be dictated by the patient’s preference and economic considerations.

Dr. Barry Eppley

World-Renowned Plastic Surgeon