I've written before about the hollowed look that develops above the eye,
and want to revisit it here.
There is lid skin laxity, and the area above the eye sits hollow.
Some patients receive fat grafting alone, but the upper-lid fat pad has often retracted toward the orbital rim — that's the underlying issue in many of these cases.
In Asian eyelid anatomy, the fat pad normally extends much further down toward the lid margin; here, it has not.
When we reposition the retracted fat pad downward and supplement with a small volume of grafted fat, the result tends to be excellent with very little graft volume needed.
Over-grafting tends to leave irregular, unnatural-looking lumps.
One month post-op.
The fat has begun to take, and the swelling has settled considerably. The crease is still a touch unsettled at one month.
Some residual swelling remains at the one-month mark, and the scar is still visible — both will fade with time.
The result came out well — a satisfying case.