Introduction
The eyes are often considered the windows to the soul, and they are also one of the first areas of the face to show signs of aging. As we get older, the orbital fat around the eyes can shift, leading to the formation of eye bags, dark circles, and a tired appearance. Orbital fat repositioning is a cosmetic procedure that aims to address these issues by redistributing the fat in the eye area, creating a more youthful and refreshed look. In New York City, there are many highly skilled surgeons who offer this procedure. This article will explore the top ten aspects related to orbital fat repositioning in the eyes in New York City, including surgeons, procedures, and patient considerations.
1. Understanding Orbital Fat Repositioning
What Happens to Orbital Fat with Age?
As we age, the structure and position of orbital fat change. The connective tissues that hold the fat in place weaken, causing the fat to protrude and form eye bags. Additionally, the loss of volume in the surrounding areas, such as the upper cheeks, can lead to the appearance of dark circles. The orbicularis oculi muscle around the eye also becomes looser, and the skin on the lower eyelids may sag and develop wrinkles.
How Orbital Fat Repositioning Works
Orbital fat repositioning is a surgical technique that involves taking the excess orbital fat from one area, typically from the eye bags, and moving it to another area, such as the tear trough. This helps to fill in the hollows under the eyes, reduce the appearance of dark circles, and smooth out the transition between the eyelids and the cheeks. Unlike simply removing the fat, which can sometimes result in a hollowed - out look, fat repositioning maintains a more natural appearance.
2. Top Surgeons for Orbital Fat Repositioning in New York City
Dr. Andrew Jacono
Dr. Andrew Jacono is a well - known double - board - certified plastic surgeon in New York City. He specializes in facial cosmetic surgery, including lower blepharoplasty with orbital fat repositioning. Dr. Jacono tailors each procedure to the patient's individual needs, recognizing that not all patients have the same eye concerns. He uses fat transposition techniques to move the fat from the eye bags to the tear troughs, creating a more youthful and natural look. For example, he performed a fat transposition lower eyelid lift on a 43 - year - old woman, resulting in a significant improvement in her under - eye appearance.
Dr. Brett Kotlus
Dr. Brett Kotlus is a cosmetic oculoplastic surgeon in NYC. He offers lower eyelid fat pad reduction/repositioning procedures. Before the surgery, he carefully marks the bulging fat pouches and areas of hollowing while the patient is in a seated position. He then uses local anesthesia and approaches the lower eyelid fat either from the front of the eyelid or from behind the eyelid. He can sculpt the fat pads and reposition the fat to fill the under - eye hollows, treating both bulging fat pads and lower eyelid hollowing simultaneously.
Dr. John E. Sherman
With over four decades of surgical experience, Dr. John E. Sherman is a highly sought - after board - certified plastic surgeon in New York City. He frequently performs transconjunctival eyelid lifts to access the eyelid tissue from the inside, avoiding visible scarring. During orbital fat repositioning, he can skillfully maneuver towards the fat pads beneath the thin internal layers of the under - eye area and reposition them with internal sutures to smooth out the area and correct under - eye hollows.
Dr. Gary Linkov
Dr. Gary Linkov is a board - certified facial plastic surgeon in New York. He is the chief of otolaryngology and facial plastic surgery for the veterans hospital in Brooklyn. At his private practice in New York City, he offers various types of eyelid surgeries, including lower blepharoplasty with fat repositioning. He prefers the internal approach for lower eyelid surgery and can mobilize and reposition the orbital fat over the lid/cheek junction to achieve a more youthful appearance.
Dr. Adam R. Kolker
Dr. Adam R. Kolker is a plastic surgeon in New York City who brings vast experience and technical finesse to eyelid rejuvenation. He offers lower eyelid fat repositioning as part of his blepharoplasty procedures. His approach emphasizes maintaining the natural shape and "personality" of the eyes, and he can customize the fat repositioning technique to each patient's unique needs.
Dr. Lara Devgan
Dr. Lara Devgan is a highly regarded plastic surgeon in New York City. Her blepharoplasty procedures, which may include orbital fat repositioning, aim to make the eyes look more refreshed, awake, and youthful. She performs surgeries under sedation administered by a board - certified anesthesiologist and uses protective corneal shields to ensure patient safety. Dr. Devgan is known for her ability to deliver beautiful and natural results.
Columbia's Oculoplastic Experts
The oculoplastic experts at Columbia offer a range of surgical and cosmetic treatments related to the eyes, including orbital fat repositioning as part of blepharoplasty. Their multidisciplinary approach involves working with various other services across Columbia, ensuring comprehensive care for patients. They are specially trained in performing orbital surgeries and can handle complex cases related to the eye area.
Dr. David Cangello
Dr. David Cangello is a board - certified plastic surgeon in New York City. He offers blepharoplasty procedures that may include repositioning of fat from the lower eyelid or fat grafting into the “tear trough”. He takes an artistic approach to plastic surgery, visualizing enhancements that would perfectly complement a patient's natural anatomy. He carefully selects the appropriate incision sites and techniques for each patient to achieve the best results.
3. Types of Orbital Fat Repositioning Procedures
Transconjunctival Fat Repositioning
This approach involves making an incision inside the eyelid, so there are no visible external scars. Surgeons can access the orbital fat through this internal incision and reposition it to the desired area, such as the tear trough. It is often preferred for patients with good skin elasticity, as it allows for the correction of fat protrusion without the need to remove excess skin. For example, Dr. John E. Sherman frequently uses the transconjunctival approach in his lower eyelid surgeries.
Transcutaneous Fat Repositioning
In a transcutaneous fat repositioning procedure, an incision is made just below the eyelashes. This approach is suitable for patients who not only have excess orbital fat but also have loose or sagging skin on the lower eyelids. The surgeon can remove the excess skin along with repositioning the fat. However, there is a risk of a visible scar, although skilled surgeons like Dr. Andrew Jacono take great care to ensure that the scar heals well and is less noticeable.
Fat Repositioning with Canthopexy
Canthopexy is a procedure that involves tightening the lateral canthal tendon of the lower eyelid. When combined with orbital fat repositioning, it helps to prevent the lower eyelid from changing shape after the surgery and can recreate the almond - shaped eyes of youth. For instance, Dr. Andrew Jacono often performs canthopexy along with fat transposition lower eyelid lift to avoid complications such as ectropion (drooping of the eyelid corner).
4. Pre - operative Considerations
Consultation with the Surgeon
A thorough consultation with the surgeon is crucial before undergoing orbital fat repositioning. During the consultation, the surgeon will evaluate the patient's eye condition, medical history, and aesthetic goals. They will discuss the available treatment options, including the type of fat repositioning procedure that is most suitable for the patient. The patient should also ask any questions they have about the surgery, recovery process, and potential risks.
Medical Evaluation
Patients will need to undergo a medical evaluation to ensure they are in good health for the surgery. This may include a physical examination, blood tests, and an eye examination. Conditions such as glaucoma, chronic dry eye, hypertension, and heart disease may affect the patient's suitability for the procedure. If a patient has any pre - existing medical conditions, the surgeon may require them to obtain approval from their primary care physician or an ophthalmologist.
Pre - operative Instructions
Surgeons will provide patients with pre - operative instructions to follow. These may include discontinuing certain medications and supplements that can increase bleeding risks, such as NSAIDs, aspirin, and vitamin E. Patients are also usually advised to stop smoking, as tobacco products can decrease blood flow to the skin and compromise the healing of the surgical site. They may need to arrange for someone to drive them home after the surgery and fill prescriptions for pain medication and antibiotics in advance.
5. Intra - operative Process
Anesthesia
The choice of anesthesia for orbital fat repositioning depends on various factors, including the patient's preference, the extent of the procedure, and the surgeon's recommendation. Local anesthesia with sedation is commonly used for lower eyelid procedures. It allows the patient to be relaxed and comfortable during the surgery while numbing the eye area. In some cases, general anesthesia may be used, especially if the patient is having a more extensive blepharoplasty procedure or if they are very anxious about the surgery.
Surgical Steps
If a transconjunctival approach is used, the surgeon will first retract the lower eyelid and make an incision through the conjunctiva. They will then access the orbital fat, sculpt the fat pads as needed, and reposition the fat to the desired location, such as the tear trough. The internal incision may be left open or sutured with dissolvable stitches. In a transcutaneous approach, the surgeon will make an incision below the eyelashes, remove any excess skin if necessary, and then reposition the fat before closing the incision with sutures.
6. Post - operative Recovery
Immediate Post - operative Period
After the surgery, patients will be taken to a recovery room where they will be monitored by medical staff. They may experience some swelling, bruising, and discomfort around the eyes. Cold compresses are often recommended to minimize swelling and bruising. Patients may also be prescribed pain medication to alleviate any pain. It is important for patients to keep their head elevated when lying down to reduce swelling.
Recovery Time
The recovery time for orbital fat repositioning varies from patient to patient. In general, it takes about 7 - 10 days for the swelling and bruising to significantly subside, but some degree of swelling may linger for several weeks. Most patients can return to work within one to two weeks, depending on the nature of their job and individual healing progress. It is important to follow the surgeon's post - operative instructions, which may include avoiding strenuous activities, using eye drops as prescribed, and keeping the surgical area clean.
Long - term Results
Once the recovery is complete, patients can expect to see a more youthful and refreshed appearance around their eyes. The repositioned fat helps to fill in the hollows, reduce the appearance of eye bags and dark circles, and create a smoother transition between the eyelids and the cheeks. The results of orbital fat repositioning are usually long - lasting, although the natural aging process will continue over time.
7. Benefits of Orbital Fat Repositioning
Improved Appearance
One of the primary benefits of orbital fat repositioning is the significant improvement in the appearance of the eyes. It can reduce the signs of aging, such as eye bags, dark circles, and sagging skin, making the eyes look more youthful and refreshed. This can have a positive impact on a person's self - esteem and confidence.
Natural - looking Results
Unlike some other cosmetic procedures that may result in an artificial or over - done look, orbital fat repositioning aims to maintain a natural appearance. By redistributing the existing fat, the surgeon can create a more balanced and harmonious look around the eyes, rather than simply removing or adding large amounts of tissue.
Long - term Solution
The results of orbital fat repositioning are relatively long - lasting compared to non - surgical treatments such as fillers. Once the fat is repositioned, it can integrate with the surrounding tissues and provide a more permanent improvement in the eye area.
8. Potential Risks and Complications
Bleeding and Infection
As with any surgical procedure, there is a risk of bleeding and infection. Surgeons take precautions to minimize these risks, such as using sterile techniques during the surgery and prescribing antibiotics post - operatively. However, patients should still be aware of the signs of infection, such as increased pain, redness, swelling, or discharge from the surgical site, and report them to their surgeon immediately.
Eyelid Retraction and Asymmetry
There is a small risk of eyelid retraction, where the eyelid may not close properly or may appear higher than normal. Asymmetry between the two eyes can also occur, although skilled surgeons take great care to ensure symmetry during the surgery. In some cases, additional corrective procedures may be required to address these issues.
Fat - related Complications
Repositioned fat may sometimes lead to complications such as prolonged swelling, fat cysts or granulomas, and contour irregularities. These complications are relatively rare but can occur. Surgeons closely monitor patients during the recovery period to detect and address any potential issues.
9. Cost of Orbital Fat Repositioning in New York City
The cost of orbital fat repositioning in New York City can vary widely depending on several factors. These factors include the experience and reputation of the surgeon, the complexity of the procedure, the type of anesthesia used, and the location of the surgical facility. On average, the cost of lower blepharoplasty with orbital fat repositioning can range from a few thousand dollars to over ten thousand dollars. It is important for patients to have a detailed consultation with the surgeon to get an accurate estimate of the cost and to understand what is included in the price, such as pre - operative and post - operative care.
10. Patient Testimonials and Before - and - After Photos
Importance of Patient Testimonials
Patient testimonials can provide valuable insights into the quality of care and the results achieved by a surgeon. Reading about other patients' experiences can help potential patients make more informed decisions about choosing a surgeon for their orbital fat repositioning procedure. Positive testimonials can give patients confidence in the surgeon's skills and the overall outcome of the surgery.
Before - and - After Photos
Before - and - after photos are another important tool for evaluating a surgeon's work. They allow patients to see the actual results of orbital fat repositioning procedures performed by the surgeon. By comparing the before and after photos, patients can get an idea of the potential improvement in their own eye appearance. However, it is important to note that individual results may vary.
Conclusion
Orbital fat repositioning is a valuable cosmetic procedure for addressing the signs of aging around the eyes in New York City. With the help of highly skilled surgeons, patients can achieve a more youthful and refreshed appearance with natural - looking results. However, it is essential for patients to carefully consider all aspects of the procedure, including the pre - operative preparation, the surgical process, the post - operative recovery, and the potential risks and complications. By doing so, they can make an informed decision and choose the best surgeon and treatment option for their needs. If you are considering orbital fat repositioning in New York City, we encourage you to schedule a consultation with a qualified surgeon to discuss your goals and learn more about the procedure.
