Under eye fat injections – do they work?

What are facial fat injections?

Fat is used as a natural filler to put back the fullness and suppleness in your face that is lost as you get older.  Small amounts of fat cells are suctioned from one part of your body- your belly, hips, thighs for example, and then this fat is placed where it is needed to make you look the way you did years earlier.

transfer fat

Where do fat injections go?

The earliest parts of the face that lose fat are the grooves under the eyes, the cheeks, and sometimes the temples and eyebrows.


This is one of my patients that didn’t like the look of bags and sunken-under eyes.

bags under eyes







I suggested a lower eyelid lift, with fat injections.  You can see she has sunken areas under her eyes where she is missing a roundness to her upper cheeks.

This is where I placed fat, by injecting tiny amounts with a thin tube (cannula) deep under the skin and muscles of the face:

under eye fat grafting







And this is what she looked like after recovering from the procedure:

before and after under-eye fat












In addition to fat injections, a minor amount of bulging fat was removed from behind the eyelid, also termed a scarless lower eyelid lift.  With these two procedures I eliminated her eye bags and the hollowing in her cheeks.

Another example of under-eye fat injections with scarless lower eyelid lift to reduce bags and hollowing:

fat grafting eyes

Fat injections vs. fillers

Much of what can be accomplished with fat under the eyes can also be done with filler injections. Fillers (like Restylane and Juvederm) are in-office procedures, performed in minutes, and often with little downtime.


The benefits of fat are:

1. Fat lasts longer (possibly permanent) when compared to the most popular fillers

2. Fat is a natural part of your own body

3. Fat is softer than fillers

4. Fat reserves tend to be plentiful


The drawbacks of fat injections:

1. Your body may absorb some of the fat requiring a second treatment

2. Fat injections have more downtime than fillers (about 1-2 weeks)

3. Fat injections tend to cost more than fillers


How to ensure fat injections will last

There are many ways to handle and process fat to be used for injections, or fat grafting.  Gentle handling with sterile techniques and meticulous injection practices help to ensure the best chance of long-term fat cell survival.  Many surgeons will quote a 50% – 70% rate of fat acceptance.  For this reason, slight over-correction is desirable immediately after the procedure.

I centrifuge the fat at low speeds after collecting it with low-force suction. This purifies and condenses the fat cells.

purified adipocyte






The final product is a golden slurry of your own fat. I inject fat in small amounts using a one milliliter tube (1/5 of a teaspoon) as depicted below.  Each injection layer consists of one tenth or one twentieth of this tube.  Very small fat deposits create a smooth and accurate fat placement.

injection fat grafting







So yes, fat injections under the eyes can effectively fill in hollow and sunken cheeks and under-eyes.  The combination of fat grafting with lower eyelid surgery, facelift surgery, or even brow lifting is a great way to look younger without looking “done”.



Brett Kotlus, M.D.

135 E. 71 street

Phone: 212-882-1011