What to do about 1 under eye bag remaining after surgery?

Dear Dr. Irwin: I underwent lower blepharoplaty 8 months ago for fat repositioning and fat pad removal. I still have a large bag on one cheek that was present prior to the surgery. I have consulted my physician about this and was told this is a separate problem requiring additional surgery. I do not have excess skin just the "pad" which gives my face a lopsided appearance. I consulted another surgeon who recommended Juvederm to correct the appearance of the asymmetry, Juvederm made it worse. Are there any options other than surgery? Is the procedure to correct this condition similar to blepharoplasty? Rhonda

Rhonda –  I can’t tell you what the right thing to do here is but I think I can help you in your thinking about it to help get you to a good solution.  Hope that makes sense.

The first thing is to figure out (with your doctors?) what is causing the pad.  Is the pad a small lump of fat?  Is it the lower edge of the orbicularis oculi muscle that’s sagging?  Is it excess skin?  It’s likely to be one of these 3 or a combination of them.  What is your prior doctor’s opinion on this?  First, you need a diagnosis of the problem. 

If their explanations aren’t satisfactory, the next thing to do is schedule with 2 other plastic surgeons for a short (hopefully no charge) consultation and hear their opinions.  If they disagree, then even possibly get a third opinion until you feel confident that someone has nailed the diagnosis and then given you some reasonable options.  Without seeing you it’s impossible to know if the Juvederm just wasn’t a good idea or it was a placement problem.  

 The worst thing to do in this situation is to rush into another surgery.   Hope this helps.  Dr. I

Dr. Brandith Irwin, MD

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