This is a 38 year-old female who presented to the office with complaints of aging of the lower eyelids. The patient noted that her lower eyelids made her look older than her stated age. On exam, she had bilateral dark circles under her eyes (tear trough deformity) and overall aging of the skin of her lower eyelids. She had a clear distinction between the skin of her lower eyelids and the skin of her cheeks. She also had a loss of volume of the inner cheek area which made the aging of her lower eyelids look worse. We recommended bilateral lower eyelid augmentation blepharoplasties to be done under local anesthesia at our AAAASF accredited surgical facility in Downers Grove, IL. The patient had the procedure done with injection of local anesthesia with hyaluronidase to the lower eyelids. A transconjunctival incision was made inside the eyelids to remove some of the excess intraorbital fat and release the arcus marginalis to correct the tear trough deformity. A lower eyelid skin flap was raised to redrape the lower eyelid skin and remove the excess. Fat was harvested from around the patient’s belly button and processed into microfat and nanofat. The microfat was used to inject into the cheeks and lower eyelids to correct the volume deficiency of the medial cheeks. The nanofat was used to inject into the area of the dark circles (tear trough deformity) to improve skin texture and thickness. Laser resurfacing of the lower eyelids was done nine months later.
