This is a 59 year-old female who presented with skin excess, dark circles and bags of her lower eyelids. We recommended a lower eyelid blepharoplasty under local anesthesia via a subciliary incision. The excess skin was excised and a lateral orbicularis hitch suture was placed to smooth out the lower eyelid contour. The patient’s fat was harvested from around the belly button and processed into nanofat for the tear trough and microfat for the periorbital area. The nanofat was injected into the tear trough and resulted in less skin pigmentation, a smoothing of the tear trough area of thickening of the skin. The microfat was used to give volume to the area around the eyes and the upper cheeks. The patient had fractional CO2 laser resurfacing of the lower eyelids three months later to improve the skin texture. Notice the correction of the tear trough deformity and the overall smoothing of the lower eyelid contour. Her lower eyelids have a much more youthful appearance.
