Fat Transfer & Blepharoplasty

Blepharoplasty

Treatment of upper and/or lower eyelids has traditionally been with a Blepharoplasty. This is a procedure that involves the removal of any excess skin, along with some fat and possibly also eyelid muscle. For example, the ‘bags’ under our eyes were considered a result of the downward movement of fat, skin and soft tissue. The mainstay of treatment has been the removal of fat from these ‘bags’. This type of procedure often results in a sunken, hollowed-out appearance of the lower eyelid area.

Fat Transfer

Fat Transfer (correctly termed Autologous Fat Transfer or AFT) is the process by which a patient’s own fat is removed from one area (usually the abdomen, flanks or buttock), processed and placed into facial areas of concern to the patient most commonly the lower eyelid, cheek, eyebrow and temporal areas.

Fat transfer will restore the “fullness” of the treated area that is usual in younger faces.

Is Blepharoplasty or Fat Transfer best?

Lower Eyelids
In recent times it has become appreciated that as we all age we tend to loose fat from our face. The best approach to the ageing lower eyelid is now thought by many to be replacement of fat into this area rather than a blepharoplasty. At the same time as replacing fat (i.e. fat transfer) any excess skin is removed.

Upper Eyelids
The main problem here is usually excess, loose skin. Often the hollow between the eyebrow and upper eyelid will also benefit from fat transfer.

Cheeks and Temporal Areas
With age, these areas also tend to loose fat and ‘hollow-out’. Fat transfer to these areas is also very good at restoring a more youthful appearance to the face.

Our Approach

Dr Bellaney has been performing blepharoplasties for over 10 years. However,  now rather than  from performing a  blepharoplasty, in many patients he uses  a combination of fat transfer and excision of loose skin to obtain optimum results.

This  patient was treated  by Dr Bellaney with an upper lid Blepharoplasty alone.

The Process

Fat is removed with a very minor tumescent liposuction procedure. Typically, a small amount of tumescent anaesthetic is placed into the fat around the abdomen or buttocks. Approximately 20-50mls of fat is removed. This process is very well tolerated.

Once the fat is extracted it is prepared for transfer and placed into small vials. The area/s of fat loss to the face are marked out and local anaesthetic is placed at a few specific locations on the face. A period of waiting will occur while the anaesthetic numbs the nerves suppling the skin to the treated area. Once the area to be treated is numb, treatment is commenced. It can take 10-30 minutes to treat each area. It is usual to feel a sense of pushing and pressure during this time but it should not be painful.

Subsequent to this, any loose skin is then removed by placing a fine incision along the crease of the eyelid, removing the excess skin and closing the incision with very fine sutures. In addition, a chemical peel may be used to improve the appearance of the eyelid skin.

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Other areas that can be treated by AFT

Any area of fat loss can be treated. These include the cheeks, temples and eyebrow areas.

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Need for repeat procedures

AFT requires the establishment of blood supply to the transferred fat in order to become permanent. Fortunately in the area below the eye, most of the fat injected remains permanent and so only 1-2 treatments are generally needed.

In other areas often only 20-30% of the fat transferred remains permanent, so 4-5 procedures may be required for the ultimate effect in these areas.

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How long does the procedure last?

Unfortunately the ageing process and slow loss of our facial fat continues despite surgery! However, the fat replaced by AFT generally takes many years off the appearance of a patients face.

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Side Effects

Common side effects are bruising and swelling, particularly when the lower eyelids are treated. This can last up to a week to 10 days. Pain is usually mild to moderate post-operatively and easily managed with oral pain relief.

Extremely rare side effects such as inadvertent injection into a blood vessel leading to the eye have occurred in association with the use of a sharp injecting cannula. Blunt tipped cannulas are now used and, in combination with current injection techniques, should eliminate this problem.

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What about recovery?

Post-operatively, patients are asked to apply cold compresses over the first 24-48 hours, elevate their head for several days and use antibiotic eye drops or oral antibiotics for a week. There is often some swelling and bruising associated with the procedure which resolves over the ensuing week. The eyelids can be stiff and sore for up to several weeks. Patients cannot wear contact lenses for up to two weeks following the procedure as they may irritate the eyes. In most cases, make-up can be worn after about 10 days.

Eyelid surgery is a surgical procedure and the body has to heal before the full benefits can be seen - this will take up to several months. For many people, this procedure takes years off the appearance of their face. After this procedure patients have a softer, more fresh and youthful look to their eye area.

If you’ve been wondering how to get rid of your tired saggy eyelids and would like additional information, we would be happy to schedule a consultation.

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