Fat transfer can dramatically rejuvenate the EYELID CHEEK JUNCTION, in addition to other facial areas. The use of fat transfer for rejuvenation of the aging face, nasolabial folds, and mouth areas have been well described. I believe one special and unique area to treat is the eyelid cheek junction. This area drops or descends with age and adds to the bags and circles associated with tired and old eyes. This educational writing will focus on this area and how we can look younger and more rested with this cosmetic technique. It was written at the request of a patient from Wilmington, DE.
Overview:
It’s important to understand what happens as the eyelid and cheeks age. There is descent of tissue, loss of skin elasticity, herniation of eyelid bags, and loss of fat in key anatomic locations. The culmination of these factors are older and tired looking eyelids. In addition, we classically see “bags and circles” and “tired eyes.” This is the most common appearance of old eyes. People will say, “It runs in my family.” But the truth is that everyone ages like this, but we age at different rates. The eyelid cheek “junction” is the specific area at the bottom of the eyelid bags, and this location is also the top of the cheek. This area moves down with aging and contributes to looking old and tired.
The three cosmetic surgery operations to improve these changes are called an eyelid tuck or lift (blepharoplasty), a facelift, and fat transfer. Fat transfer is also called grafting. With eye tucks, small incisions are made beneath the eyelashes to elevate the tissues and smooth out the skin, muscle, and fat pockets. This operation has amazing results, but it doesn’t factor in fat loss that occurs, as mentioned above. Facelift operations elevate tissues to more youthful positions, and this includes the cheek area. But when fat is deficient or lost, fat transfer becomes a method to get even better results. I believe the greatest and most significant benefit comes when fat is combined with these operations to help rejuvenate the eyelid cheek junction. It elevates this junction to a more attractive and youthful position.
The Eyelid Cheek “Junction” and Improving Cosmetic “Function”:
I mentioned the aging of the eyelids above, but the cheeks and upper face are aging simultaneously and dropping too. This pulls the junction down to a lower and less attractive position. A youthful junction is higher up and not demarcated. This junction is part of a continuous and natural flow from the eyelid onto the cheek. It’s a natural flow which I call a “cosmetic function.” Honestly, a function is moving, like your hand moves, and it has normal function when it grasps something. But I’ve coined this term as “cosmetic function.” This means looking natural and more youthful. It’s like a job for this area. I cosmetically work on it to make it more normal looking and give it better function.
Treatment :
As I described above, a large part of the lower and older looking eyelid cheek junction is its descent, loss of fat in the cheeks, fat bag herniation, and skin elasticity loss. The cheek area is actually anatomically part of the the upper face. The treatment to rejuvenate these areas can be done with fat transfer; but facelift or cheek lift surgery can be done, in addition, to get better results compared to fat transfer alone. This is because surgery will address other parts of the aging process, and the transfer alone addresses only part of the problem.
With fat transfer or grafting, the fat is transferred to the “malar” or cheek area to help fill up the loss of volume that occurs here. The increased volume fills up the “skin envelope” and makes it look fuller and prettier. This procedure can work, but it wouldn’t address the bags of the eyes and the loose skin. Benefits would occur but not as much as if it is combined with cosmetic surgery on the eyelids or cheeks.
A blepharoplasty will smooth out the folds, bags, and excess skin. This will give us a more attractive and youthful eyelid area. This alone will not elevate the eyelid cheek junction. Fat transfer or a mini facelift can be added. A facelift operation can suture the SMAS or deeper muscle area higher in this location to also achieve the volume and filling in the loose skin envelope. My LAVVNDR facelift will specifically address this area. Fat also can be transferred at the same time giving the best rejuvenation, because we now are treating all the aging problems, not just lost fat. My LAVVNDR LIFT is a trilaminar, composite, deep plane facelift, that I have created after 30 years of cosmetic surgery. You can read about this in detail by linking now.
Recovery:
Recovering from this type of cosmetic surgery usually has minimal pain but significant bruising and swelling. This will take time to go away. Postoperative eyelid instructions after surgery will entail closing and icing of the eyes. Eyelid massage methods will often be necessary to help maintain the motion of the lower eyes. This massage is analogous to range of motion exercises for orthopedic knee procedures to maintain normal motion and movement. You will be taught how to do this, and it’s very easy. Final results aren’t completely seen for a month or so, but most people are very happy with their results before this time.
Summary:
Fat transfer or grafting is a wonderful method of facial rejuvenation. Classic areas treated are the cheeks, nasolabial folds, and the lips. Transfer of fat can also be used to elevate the EYELID CHEEK JUNCTION, giving it a higher and more youthful appearance. Often the best method to improve this area is combining the fat with an eyelid tuck or a facelift. The improvement and elevation of this junction gives it a more normal “COSMETIC FUNCTION” that is extremely natural and pretty. Please come in for a consultation. It will be very thorough, and I will review your options in complete detail.
