Fat Injections

There are several possible causes for dark circles around the eyes. Some are medical conditions, like allergies and/or thyroid disorders. Identification of these potential medical conditions and, if present, treatment can improve upon the appearance of the dark circles around the eyes. Dark circles can also be due to pigmentation of the skin, blood vessels beneath the skin, and hollowness. Pigmentation of skin is best treated with skin care products and skin resurfacing techniques, like chemical peels or laser resurfacing. Blood vessels beneath the lower eyelid skin are difficult to treat, but may improve with laser treatments. Hollowness of the lower lids is due to fat in the lower lids becoming more prominent, thus creating a bulge or fullness AND cheek tissues losing volume and descending. One option for treatment of this condition is augmentation. While fat transfer is a potential option for volumizing the cheek, fat transfer to the very thin skin of the lower lid may result in contour irregularities. Filler augmentation of the hollowness with a hyaluronic acid filler is a nice option and, if a contour irregularity occurs, it is easily treated with injection of the enzyme, hyaluronidase, which breaks down the product. A surgical option for this condition is lower lid blepharoplasty with fat repositioning/transposition. In this surgery, I keep the fat of the lower lid attached to its blood supply and then reposition the fat from areas of fullness to areas of hollowness, thus providing a more youthful contour between the lower eyelid and cheek.

Fat transfer to the cheeks is a wonderful way to achieve volume in volume-depleted areas. Do I overfill the area? That depends on your preference. We anticipate loss of some volume within the first year of the procedure. The amount of volume loss is variable and dependent upon several factors such as method within which fat is harvested and patient-specific issues such as history of smoking. We could overfill the area and you may have an overfilled appearance that may last several weeks/few months. If you wish to minimize this potential for overfilled appearance in the short term, we could fill to correction. If you feel you would benefit from more volume after that first year, the addition of hyaluronic acid filler (Juvederm) may be a nice complement to the final result.

Typically, the fat is removed from the abdomen.

Fat is usually harvested from the abdomen. Occasionally, patients desire body contouring (liposuction). I work with a board certified plastic surgeon who performs the body contouring procedure; he then provides me with the fat. I process the fat and re-inject it into areas of the face.

Cheek implants are an excellent option to achieve volume in the cheek region. Another alternative is fat injection. A non-surgical option is injection with filler, such as Radiesse or Juvederm. To address jowl formation and sagging of cheeks, you may benefit from either cheek lift or, more likely, a facelift.

These lumps could be actual fat. These areas sometimes dissipate on their own. Occasionally, steroid injection helps decrease the appearance of lumps if there is swelling associated with it. However, if the lumps persist, it may be a lump of fat, in which case, resection may be necessary. I prefer using a hyaluronic acid to the lower lid hollows. If there is a persistent lump from hyaluronic acid, this is easily treated with injection of hylauronidase, an enzyme that breaks down the hyaluronic acid, usually within 24-48 hours.

Posted by Rami K. Batniji, M.D., F.A.C.S.