A word of caution...

With the increased popularity and rise of cosmetic surgery procedures as well as new techniques, also comes inherent risk. Of recent, we have seen more and more complications involving fat injections in an attempt to reconstruct the soft tissue to lower eyelids as a result of overresection.

Because of the thin skin under the eyes, a common occurrence with fat injections would be the formation of residual lumps. Despite "tenting" (adding additional fat around the lumps to tent the skin), lumps still remain under the skin and are quite noticeable. Microliposuction can assist with the removal of fat but can reposition the fat in other areas under the eye. As a result, additional lumps can form. For existing lumps, a transconjunctival or transcutanesous blepharoplasty may need to be performed for removal of fat.

Dr. Codner does not subscribe to fat injections to the undereye area. His preferred methods when performing reconstruction to the lower eyelids would be to use AlloDerm as a lower lid spacer or dermal-fat grafting. Alloderm is specially prepared human tissue which would obviate the need for a donor site and has proven to be a safe and effective material. Dermal-fat grafting should not be confused with "fat injections" and entails a two step surgical procedure. The first step would involve removing the dermis from a donor site such as the abdomen. The second step would involve insertion to undereye area. Because the fat is attached and supported by the dermis constituent, it is much more reliable than fat injections where the liquid cells can shift during the healing phase. Dr. Codner has had great success with AlloDerm and dermis-fat grafting in conjunction with lower eyelid revision.