Dr. Sam Lam Plastic Surgery Forum

Hi dr lam

first of all i just want to say that I admire you

i've spoken to several doctors and they all said the same thing, and now i want to ask you for reassurance, they said that if you get upper and lower bleph done, the fat will come back if you gain weight (30 lbs and more) or as you age due to the fat increase in the eyesocket which would obviously affect the eyelids.. is this true?

If so, you are then required to do the two procedures all over again?

interesting. this is one of the few things that i would completely disagree with. in general, you are born with a limited amount of fat in the eye area that is the only fat in the body that should not fluctuate with weight. that being said, you should not have a problem with fat removal ad weight gain as far as I know.

Now, I don't know if you have reviewed my website thoroughly but I am totally opposed to upper and lower eyelid surgery without fat grafting, which unfortunately can be affected with weight change. However, I think removal of fat from the upper and lower eyelid without fat grafting is a travesty. Only an in person consultation with me and a review of photographs will have you make sense of this. I do the exact opposite of what surgeons out there do because honestly I hate the look of a blepharoplasty.

For example, most people do not have a fat bag they have hollowness under the fat pad that needs to be filled. Perhaps the best analogy that I have heard is when you are young the lower eyelid is at high tide. When you get older the tide recedes and exposes the rocks (i.e., the bags), why then should we remove the rocks at low tide? Instead, we need to make the tide high again. I know that all of this does not make too much sense. Only a consultation with me will change your mind and your opinion.
Best,
SML

Thank you for your response,

However what you said

" in general, you are born with a limited amount of fat in the eye area that is the only fat in the body that should not fluctuate with weight."

has me wondering why almost ALL overweight people have very small eyelids,

i.e.

http://l.yimg.com/img.tv.yahoo.com/tv/u ... 133121.jpg
http://d.yimg.com/us.yimg.com/p/afp/200 ... 68x512.jpg
http://www.usmagazine.com/files/rosie_blog_5.jpg

Is it a coincidence or could there be a connection?

okay, there is a difference between pre-septal fat and post-septal fat. most fat that is removed during a blepharoplasty is post-septal and not pre-septal. the post-septal fat is the fat that does not really fluctuate. the pre-septal fat can fluctuate like the rest of the body. that "pre-septal" fat is the same fat you have all over your body under your skin. the post-septal fat is the unique fat pads we have behind a layer called the orbital septum.

Ok thanks for clearing that up for me

by the way i did a search on google "blepharoplasty weight gain", and your website was the first one that popped up

no problem.
best wishes,
sml