Under-Eye Fat Transfer

What is an under-eye fat transfer?

An under-eye fat transfer is a cosmetic procedure that uses fat from your body to fill in sunken, hollowed areas beneath your eyes. A fat transfer is a natural type of dermal filler. Your healthcare provider uses liposuction to draw fat cells out of your belly, hips or thighs. They purify the cells and inject them into the skin below your lower eyelids. This cosmetic procedure can make your eyes look less tired and make you appear younger.

What are dermal fillers?

Dermal fillers are a type of nonsurgical facelift. Dermal, or dermis, means skin. Healthcare providers inject dermal fillers (also called facial fillers) to plump up skin that’s losing volume due to aging. Fillers also smooth away fine lines and wrinkles, making them less noticeable.

What’s the difference between a fat transfer and dermal fillers?

Most dermal fillers are lab-made substances. These off-the-shelf dermal fillers are ready to use. They’re a nonsurgical cosmetic treatment. A fat transfer is a natural dermal filler that uses your body’s fat cells.

There are more steps when you choose a fat injection over an off-the-shelf dermal filler. The procedure starts with liposuction (a type of cosmetic surgery) to remove fat cells from certain areas of your body. After purifying the fat cells, your healthcare provider then injects the cells into the area below your eyes. Having liposuction increases your risk for problems and makes for a longer recovery than getting a lab-made dermal filler. It’s also uncommon for healthcare providers to harvest enough fat to perform an under-eye transfer.

Who gets under-eye fat transfers?

An estimated 3 million Americans get some type of dermal filler each year. You may want an under-eye fat transfer or other dermal filler to:

• Achieve a more youthful and energetic (less tired) look.
• Get rid of bags below your eyes.
• Minimize dark circles under your eyes.
• Plump sunken hollows under your eyes and cheeks.
• Reduce the effects of aging like sagging skin and wrinkles.
• Smooth creases or fine lines around your eyes.

Who shouldn’t get an under-eye fat transfer?

To get liposuction and an under-eye fat transfer, you need to have enough body fat for the procedure. People who are extremely thin, exercise intensely or are pregnant may need dermal fillers instead.

People who smoke may not be good candidates either. Smoking can affect how well your body heals from liposuction and responds to the fat transfer.

How long does an under-eye fat transfer last?

Results from an under-eye fat transfer may last a lifetime. It can take up to four months to see the complete results. During this time, the grafted fat reestablishes a new blood supply to help it survive. Because your body absorbs about half of the transferred fat, your healthcare provider will inject a larger volume of fat cells than necessary. If you’re dissatisfied with the outcome, they may recommend another fat transfer procedure.

What other fat-injection procedures may take place with an under-eye fat transfer?

Treating the areas underneath your eyes requires a small amount of fat. You may want more extensive liposuction to remove more fat and shape your figure. During the same appointment, you can also choose to inject this fat into other areas of your body. These procedures include:

• Butt augmentation (Brazilian butt lift).
• Hand rejuvenation.
• Fat transfer breast augmentation.
• Lip augmentation.

What surgical cosmetic procedures may take place in addition to an under-eye fat transfer?

Depending on your aesthetic goals, your healthcare provider may recommend cosmetic facial surgery. You may get these procedures in addition to, or instead of, an under-eye fat transfer or dermal filler. These more invasive surgical procedures require a longer recovery. They include:

• Brow lift.
• Cheek implants or other types of facial implants.
• Facelift (rhytidectomy).
• Eyelid surgery (blepharoplasty).

Who performs under-eye fat transfer procedures?

Cosmetic surgeons or plastic surgeons perform liposuction and under-eye fat transfers. You should select a provider who has experience with this specific type of dermal filler.

What happens before an under-eye fat transfer procedure?

Your healthcare provider will examine your face and discuss your treatment goals. This information helps determine the correct amount of fat to remove and inject. Your provider may mark your face to guide the injections. Photographs can help you see before-and-after results.

You should tell your healthcare provider if you:

• Are pregnant or breastfeeding.
• Have an active skin disease or are getting skin treatments.
• Smoke or use nicotine products, which can slow the healing process.
• Take nonsteroidal anti-inflammatory drugs (NSAIDs), blood thinners (including aspirin) or supplements that may increase your risk of bleeding and bruising.

What happens during an under-eye fat transfer procedure?

An under-eye fat transfer is an outpatient procedure that takes approximately 30 minutes to 60 minutes. The procedure may take place in a surgical center or hospital. You go home the same day, but someone else should drive you.

For an under-eye fat transfer that requires a small amount of fat, your healthcare provider:

1. Gives you IV sedation and administers anesthesia to numb the liposuction sites.
2. Uses a thin needle and syringe to remove fat deposits from your body.
3. Spins the fat cells in a centrifuge device to filter out impurities.
4. Sterilizes the skin on your face and applies a numbing anesthetic.
5. Uses a very thin needle to inject tiny amounts of fat into the skin below your lower eyelids in a grid-like pattern. This is fat grafting. You may feel a slight pinch or sting, but the actual fat transfer shouldn’t be painful.

What are the side effects of an under-eye fat transfer?

You may experience these side effects from liposuction or an under-eye fat transfer:

• Bleeding.
• Bruising.
• Infection.
• Lumps or cysts.
• Skin damage or scarring.
• Swelling (edema).

What are the benefits of an under-eye fat transfer?

An under-eye fat transfer is a natural way to enhance your appearance. As a bonus, you’ll lose a small amount of fat from your abdomen, hips or thighs.

Compared to lab-made dermal fillers, a fat transfer offers these benefits:

• No risk of an allergic reaction.
• Potentially permanent results (outcomes vary from person to person).
• Softer, more natural look and feel.

What are the risks of an under-eye fat transfer?

In very rare instances, the filler may go into a blood vessel instead of underneath your skin. The filler can block blood flow and may irreversibly damage your vision.

What is recovery like after an under-eye fat transfer?

The area underneath your lower eyelids may look overly full due to the excess fat cells. This puffiness will subside as your body absorbs some of the fat cells during the next four to six months. You can apply cold compresses to your face to minimize discomfort. And you should wear sunscreen every day to protect your skin.

Depending on the extent of the liposuction procedure, you may need drainage tubes or a compression bandage while you heal. The liposuction areas may be swollen and tender for several weeks.

You should follow your healthcare provider’s recommendations about resuming activities. Because of the liposuction, you may need to miss a few days of work. You’ll need to take it easy (no strenuous physical activities or heavy lifting) for about two weeks.

When should I call the doctor?

You should call your healthcare provider if you experience:

• Excessive bleeding, swelling or bruising.
• Nausea and vomiting.
• Severe pain.
• Signs of infection like yellow discharge or fever.
• Vision changes.
• Signs of stroke, like one-sided body weakness.

A note from Cleveland Clinic

If your eyes look sunken, tired or have dark circles, an under-eye fat transfer or other dermal filler may refresh and rejuvenate your appearance. This type of dermal filler uses fat from your own body, so there’s little risk of an allergic reaction. Plus, the fat graft may last for life. However, a fat transfer is more involved than getting a synthetic dermal filler. You’ll need liposuction first to harvest the fat cells. Your healthcare provider can discuss the pros and cons of this type of nonsurgical facelift.