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  • Chris Thiagarajah MD

Fat Repositioning during Blepharoplasty. Is it right for you?


One of the most common questions that I get as an eyelid specialist in Denver are questions about the technique that I use during blepharoplasty or eyelid lifting. One of the most recent questions that I get are questions about fat repositioning during blepharoplasty. Here are the most common questions and answers that patients ask.

What is fat repositioning during blepharoplasty?


Often during lower eyelid blepharoplasty, surgeons remove fat from the lower eyelids to reduce the appearance of puffiness in the lower eyelid. One of the newer techniques that both my partner Jerry Popham and I employ is fat repositioning. Often in patients who have lower eyelid puffiness they can also have a tear trough deformity. A tear trough deformity is the indentation that one sees below the eyelid itself. It is actually largely due to genetics and also descent of the midface or cheek which creates a hollow below the lower eyelid. Fat repositioning involves using the fat that is in the lower eyelid and transferring it to this hollow line. This is often done by placing the fat in a pocket under the skin and muscle in the tear trough. This technique often reduces the hollows that patients complain about and have filler placed for.

How predictable or “perfect” are fat repositioning results?

Fat repositioning is predictable in that we know that it improves the tear trough appearance. That being said, it is not perfectly predictable. Some of the fat that is placed can shrink after placement. Though we do know we can predictably create a better appearance it is hard to guarantee “perfect results” with this procedure.

Why would I not elect to get fat repositioning during my blepharoplasty with Dr Thiagarajah?

There is almost no cost difference for fat repositioning during blepharoplasty in our practice so the only reason to not get the procedure would be if one either doesn’t need it or doesn’t feel bothered by the tear trough line. Do most patients get fat repositioning during their blepharoplasty? The answer to that is complicated. Most patients who don’t have a tear trough do not get the procedure because they simply don’t need it. The patients who do have a tear trough can go either way to decide if they want to get that the same time.

Does having fat repositioning during blepharoplasty affect the healing process?

Yes. Sometimes the repositioned fat can create more swelling that takes extra time to settle down compared to lower eyelid blepharoplasty alone. In general, the more procedures that are performed at the same time, the more bruising and swelling a patient will have.


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