Revision Surgery

Hollowed Upper / Lower Eyelids

Another problem which is becoming increasingly more common is hollowed out upper and lower eyelids. The hollowed eyes from prior plastic surgery lead to a gaunt appearance which actually makes you appear much older. As this problem became more evident after eyelid surgery, the old techniques became more scrutinized. As in this case, the field of medicine advances every year. I have always been impressed with the statistic that 50% of information we now know to be true in medicine is going to be obsolete in 3 years. Imagine: half of what we now know to be true in medicine will be proven false in 3 years! The fundamentals of surgery and medicine will of course take longer to change. With this in mind, it’s not surprising that eyelid surgery techniques have changed dramatically in the past 5 to 10 years. In the old days (5 years ago) it was still the norm to remove “excess” bulging fat from the lower eyelids. The entire philosophy behind this procedure is changing. Its not generally believed that the bulging fat responsible for eyelid bags is not “excess” but had merely herniates or pooches through a curtain or membrane which has weakened over time. Much like a groin hernia, the treatment is not to cut out the fat but to strengthen the membrane that holds the much needed fat inside the orbit (around the eyeball). The newer techniques have had a dramatically lower chance of hollowing eyelids and have led to even more natural youthful results.

So what about those who already have the hollowing or “tear troughs?” Micro-fat injection is the perfect option in these cases. Fat, which can be harvested from any location where fat is in excess, is processed to isolate the healthy fat cells. The live fat cells are then injected in a three-dimensional pattern into the lower eyelids one small micro-droplet at a time. Some of the fat is expected to resorb over time, but a portion of it remains after several months thereby improving the hollowness.