Do you know in which cases the procedure is indicated?
You have probably heard of fat transposition. Right? What not everyone knows, however, is that not every case is a candidate for this procedure. Let me explain.
As we age, our lower eyelids become more lax, and in some people small fat bags begin to appear under the eyes.
In most people, in addition to the fat bag, a slight depression appears just below it, which corresponds to the orbital ligament. This depression casts a shadow called the “tear trough.”
Nowadays, it is very common for patients who are bothered by dark circles or by the appearance of the skin in this area to see dermatologists to have the tear trough filled. And, of course, when this depression is mild, a small amount of filler can resolve the issue and provide a satisfactory result.
However, when there is a deep tear trough and a large fat bag in the lower eyelids, fat transposition is more appropriate. In these cases, we perform surgery to release this ligament and carry out the transposition, moving this fat bag to the malar region, and in doing so we create a natural filling of the tear trough. In other words, fat transposition is only indicated for these particular cases and is not for everyone.
But the most interesting thing is that, with the evolution of lower blepharoplasty, we no longer need to limit ourselves to simply removing fat bags. We can use this excess fat to our advantage, filling the tear trough with fat from the patient’s own bags.
And do you know why, in some cases, we prefer transposition to grafting? Because when we perform a graft, we take fat from another site and transfer it to this area. As a result, part of that fat will be reabsorbed.
Since the eyelid area has the thinnest skin in our body, some special care is needed. When grafting, small nodules may develop and become a nuisance.
I have had some cases, for example, in which I operated precisely to remove these nodules. That is why we do not usually recommend fat grafting for this area, but rather transposition.
In short, it is the repositioning or reuse of fat removed from the eyelids themselves, which is moved to fill depressions such as the tear trough.
Whether fat transposition can be used is always determined by the specialist. When transposition is not feasible, filling can be performed with hyaluronic acid.
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This content is for informational purposes only and does not replace a consultation. Whether any procedure is indicated depends on an in-person assessment, case by case. CRM SP 90.116 | RQE 11.350.
