As the eyes age, volume loss occurs in the upper and lower eyelids as well as in the tear trough, temples, and brows as it does in the rest of the face. This hollowness manifests as a circle of mild depression under and around the eye and may deepen over time, contributing to a chronically tired appearance.Volume loss under the eye in the tear trough area is often among the very first signs of aging noticed in the face.
Micro-fat transfer (also known as autologous fat grafting or fat injection) is a long-lasting and effective method to restore volume and contour around the eyes. A sample of one’s own fat is taken from the abdomen, hips or thighs, prepared, and carefully reinjected, like a filler, under the skin. Fat transfers are a natural, autologous alternative to injections of synthetic fillers.
Priorities
The most important priority in peri-orbital fat transfers is the “aesthetic vision” relative to each person’s age, overall facial proportions, and skin quality. Fat is a very powerful volumizer and can change over time with weight fluctuation, so conservative amounts of fat must be used. If these variables are not taken into consideration, the results will be obvious and unnatural.
Good candidates for fat transfers around the eyes are those with volume loss and skin tone that can support fat injections. Individuals with very transparent, thin skin may be at higher risk for lumpiness and poor outcomes.
The importance of meticulous technique comes into play for both aesthetic and safety reasons. The harvesting, preparation, and injecting of fat must be done with special attention and instrumentation. During micro-fat injections in the areas around the eyes, the harvesting and injecting technique must deliver extremely small fat particles for best results (see micro-fat transfer technique below).
Hirmand Technique
Micro-Fat Transfers using stem cell enriched fat cells:
This labor-intensive technique for fat transplantation is best suited for eyelid and peri-orbital rejuvenation. Fat is harvested fresh using custom-made small cannulas, processed to purify and to concentrate the stem cell enriched portion, which is then separated and injected through access holes, in very small quantities with special small caliber blunt cannulas to achieve the desired effect. The areas for the transfer are marked in a precise manner in an upright position at the beginning of the procedure.
It is important to note that special small caliber blunt cannulas are used for both the harvesting and the injection so as to minimize damage to the fat cells during harvesting or to the tissue in the recipient site. These blunt cannulas also deliver micro-droplets of fine fat harvest, prevent large fat clumps from forming, and result in a smooth full contour. The fat transfer preparation for the areas around the eyes is finer and the particles smaller in size than the fat used for the rest of the face. The scars associated with the harvest and injection sites are tiny and measure only a millimeter or two and are often invisible as they heal very well.
There is very little “over- correction” as most of the fat injected with this technique survives despite a small
Surgical notes:
Anesthesia: local and/or sedation
Length of procedure: 30-60 minutes depending on complexity
Outpatient/inpatient: outpatient
Adjunct procedures: Any
Recovery: none, there may be bruising and swelling requiring concealer