Can I Improve My Sunken Upper Eyelids with Fat Grafting?

A sunken upper eyelid is a common concern for many individuals. The typical causes include:

Upper eyelid ptosis (levator dysfunction)

Insufficient orbital fat

Thin subcutaneous fat layer

The amount of orbital fat varies from person to person, and generally, the upper and lower eyelids share a similar fat distribution.

For this reason:

People with naturally less orbital fat tend to have hollow upper eyelids but rarely have lower eye bags

People with more orbital fat often have fuller upper eyelids but are more prone to developing eye bags

However, if you have sunken upper eyelids AND noticeable eye bags, the issue is usually not fat volume alone—

it is most commonly related to levator muscle weakness, which requires proper medical assessment.

When the cause is:

Insufficient orbital fat, or

Thin subcutaneous fat,

fat grafting to the upper eyelid can be considered.

This technique involves harvesting fat from another area of the body, inserting it through a small incision under the eyebrow, and distributing it evenly across the upper eyelid.

It is important to note:

The grafted fat integrates within the muscle layer

Once fat is placed, removing it becomes difficult

Even if fat mass is removed, the upper eyelid may become uneven or develop unnatural creases

Therefore, despite the need to consider fat survival rates, surgeons will avoid injecting large amounts at once—

a moderate, controlled volume is the safest and most natural approach.

In the example shown, the patient received both non-incisional double eyelid surgery and upper eyelid fat grafting.

With the hollowing corrected, the overall appearance became more youthful and refreshed.

With accurate diagnosis and appropriate treatment, sunken upper eyelids can be significantly improved!