[Lari Plastic Surgery] Eyelid Fat Grafting for Improving the Eyelid Hollow: Incision Method vs. Non-Incision Method

Fat grafting surgery for the upper eyelid hollow, commonly called an eye hole, is

not simply a procedure that fills in a sunken eyelid.

Because the area around the eyes has a complex structure in which very thin skin and multiple interacting muscles are closely intertwined,

the surgery is performed based mainly on the anatomical structure of the eye and the stability of fat cell take,

while matching each patient’s features and needs to create a balanced result.

This procedure is performed for various reasons, such as when the upper eyelid is congenitally sunken,

when upper eyelid fat has been lost due to the habit of rubbing the eyes + aging,

or when the eyelid has become sunken because too much fat was removed after double eyelid surgery.

The fat used for grafting is collected from under the eyes, the abdomen, or the thighs and then transplanted into the eyelid.

The result can differ dramatically depending on where the fat is placed,

and even a 0.1 mm difference in depth or a 0.1 cc difference in volume can change the overall impression and the look of the eyes,

so the surgery must be performed delicately and carefully.

( It is not simply about putting in fat; the surgeon must identify the anatomically correct structure

and delicately place the fat in a stable area where fat take and fixation can occur smoothly. )

Loop fat grafting for the eye hole has two methods:

the non-incision method, in which a microcannula is inserted through an injection route without making an incision,

and the incision method, in which the double eyelid line is opened and the graft is placed directly.

The non-incision method

has limited injection routes, and it is not easy to place the fat in the exact layer.

In particular, if the eye hole is wide and deep, it may be difficult to fill it completely.

Its advantages are that there is no long incision scar and the surgery time and recovery period are shorter,

which is a major benefit for patients who need to return to daily life quickly and want to reduce recovery time.

The incision method

has the disadvantage of a relatively longer surgery time and recovery period compared to the non-incision method,

but because the field of view along the injection route is clearly secured, fat grafting can be performed in the anatomically correct layer,

and it has the advantage of being able to effectively fill even wide and severe eye holes.

With both methods, the key point is that it is not simply about inserting fat;

the surgeon must identify the anatomically correct structure and delicately place the fat in a stable area where fat take and fixation can occur smoothly.

Since both methods have their own pros and cons,

I recommend choosing the method that is more useful for you before undergoing surgery.

If your recovery period is tight and you only want the sunken upper eyelid to be filled,

you can undergo a simple procedure with the non-incision method and return to daily life in as little as one or two days.

If you have enough time, the surgeon may make an incision along the double eyelid line to place the fat more precisely.

Because the surgery is performed by incising the double eyelid line rather than another area,

there is no additional scar beyond the existing double eyelid scar.

Also, when the surgery is performed through an incision along the double eyelid line, it is easier to perform related eye procedures together as needed, such as double eyelid surgery, ptosis correction surgery, or double-eyelid-removal surgery, which is an advantage.

※ If the septal fat of the upper eyelid that creates a sunken look and the levator palpebrae superioris muscle that opens the eye are adhered to each other,

the muscular action that pulls the fat tissue inward can make the sunken look of the eyelid worse.

In such cases, upper eyelid fat repositioning must also be performed.

Therefore, in this case, rather than a simple non-incision fat grafting procedure using a microcannula,

it is more appropriate to undergo an incision-based fat grafting surgery that can be performed together with upper eyelid fat repositioning.

In the early period after surgery,

because even a small stimulus can move the fat and cause it to clump,

it is best to minimize irritation around the eyes.

Long periods of ice packing are also not recommended.

Similar to double eyelid surgery, stitch removal usually takes about 5 to 7 days,

and recovery-related bruising or swelling takes about 2 to 3 days for the non-incision method and 1 to 2 weeks for the incision method, depending on the surgical method.

After that, the settling process of the fat should also be checked regularly to confirm the condition of fat take.

Rather than recommending that the hollow eye area be filled to the maximum amount unconditionally,

the appropriate balance between the look the patient wants and the necessary amount of fat is determined through communication with the patient before grafting,

leading to a more satisfying result for the patient.

For eye hole loop fat grafting, the amount of fat and the purity of the fat are important,

but it is even more important whether the fat has been placed in the structurally correct layer,

so even if the procedure may not seem difficult,

extensive experience and a high level of skill on the part of the doctor determine the result.