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Volume and its Role in Lower Eyelid Surgery

Anatomy and Aging in the lower eyelid area

The lower eyelid complex is a complex area consisting of skin, muscle and fat and is one of the first areas that shows aging. Most of the time, the aging is secondary to the downward movement of the cheeks. This makes the lower part of the orbit more noticeable. The knee jerk reflex is to remove fat from the lower eyelid to treat “eye bags.” That is part of the answer. The other part of the solution is VOLUME!

I ask all of you reading this to look at a picture of yourself when you were 21. Look at the cheek mound. Look at the midface. What is there? VOLUME!

Rejuvenation of the Lower Eyelid

(On JAMA Facial Plastic Surgery) 

This article recently came into my email box. In laymen’s speak, the article advocates using some of the fat removed in a lower blepharoplasty (eyelid surgery) to replenish the volume of the midface. The funny thing is that I have been advocating this for over 5 years. I feel that rejuvenation of the face is truly a volume related issue. I believe this so much so that:

1.  I have modified my facelift technique to elevate the midface and replenish the volume of the midface.

2.  I started injecting fillers in the midface (my OcuRx procedure) over 10 years ago, and even presented my results in this area in Rome at one of the International Aesthetic Conferences.

3.  I started using micro fat grafting (go to ALMI ) 3 years ago, and used fat repositioning to correct volume over 7 years ago.

These are just a few of the techniques I use to replenish volume in the lower eyelid area. I am glad that literature is catching up to what I have been practicing for years. Volume rejuvenation in the midface is critical. It is an imperative part of rejuvenation of the area around the eyes, the face, and midface and for a natural look in these areas.

As you research facial rejuvenation, please keep in mind that volume replenishment is an important aspect of your treatment protocol. Some portion of the volume may be permanent from simply redraping of muscle layers and re-positioning fallen fat pads, etc as is done in our RT and full facelifts. Other times, volume has to be added via filler or fat injections.

For more information…call usat  281 557 3223!

Raghu Athré, MD FACS

President/Founder | Athré Facial Aesthetics





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Athré Facial Aesthetics offers a wide range of facial plastic surgery options and non-surgical cosmetic and skincare treatments. Find the right one for you by contacting our office at (281) 557-3223 or by clicking the button below to request a consultation.

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Dr. Athré is one of the few cosmetic and reconstructive surgeons in Houston who is a double board-certified Facial Plastic Surgeon, certified in Otolaryngology, Head/Neck Surgery, and Facial Plastic Surgery.

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