The problem

After cosmetic eyelid surgery there may be visible bulges of fat in the upper or lower eyelids.

How residual eyelid fat is treated

When a fat pouch consists of excess fat, it is surgically reduced with a small skin incision in the upper eyelid crease or from behind the lower eyelid, depending on the location of the fat. A bulge at the outer corner of the lower eyelid or the inner corner of the upper eyelid are the most common locations for residual fat after prior surgery.

If the apparent bulge is caused by hollowing of the surrounding area (as opposed to an excess of fat), then filling around the bulge will create a smoother appearance. This is accomplished with injectable filler or fat transfer.

Non-surgical approaches to eyelid fat reduction have been described including mesotherapy (injections of medications that melt fat). These techniques are not widely used and may result in swelling and/or bruising that is equivalent to mainstay surgical measures.

Potential complications

Over or under-reduction of fat and contour irregularities are risks of revision blepharoplasty, in addition to the risks common to all blepharoplasty procedures.