Correction of Hollow Eyes

The modern Laser Arcus Marginalis Release and Fat Grafting can correct the Hollow Eye appearance, create a refreshed, healthy and happy look to the eyes and the entire face:

Laser eyelid surgery is my specialty. Patients come to my practice in Boston for laser eyelid surgery from many states in the US, the UK and Central Asia for correction of Hollow Eyes and Dark Circles under the Eyes.(contact Dr Seckel)

Hollow Eyes are different from Dark Circles under the Eyes. Many people have Hollow Eyes as a familial or genetic trait. Hollow eyes are more common in Central Asia, particularly India. Some people develop Hollow Eyes after having eyelid surgery during which too much fat is removed.

Most people who come to see me for correction of Hollow Eyes complain that the Hollow Eye appearance:

  • Makes them look tired
  • Makes them look gaunt
  • Makes them look older
  • Are impossible to cover with make up
  • Make them look ill

Most people decide to do something about the Hollow Eye appearance because they are tired of people asking if they are tired or sick.

The Arcus Marginalis Release with Fat Grafting

Fat grafting, that is taking fat from one area of the body and transplanting it to the eyelid and cheek, is required to correct the Hollow Eye appearance.

I harvest fat from around the umbilicus, the belly button, and use the fat to plump up the Hollow Eye appearance. The incision to remove the fat is placed inside the belly button and is not usually visible.

I use the laser to make a small incision on the inside of the lower eyelid and release the Arcus Marginalis a structure which tethers the lower eyelid to the bone of the eye socket and creates a dark circle under the eye. I then place the fat over the bone and into the depression which is causing the Hollow Eye. This maneuver plumps the depression which is causing the Hollow Eye appearance.

This is called a transconjunctival arcus marginalis release with fat grafting.

Transconjunctival refers to the fact that the incision is on the inside of the eyelid through the conjunctiva, the pink skin on the inside. The benefits of the transconjunctival blepharoplasty approach are:

  • No visible scar on the eyelid
  • No change in the shape of the eyelid
  • Better access to the Arcus marginalis

The importance of the transconjunctival approach, making the incision on the inside of the eyelid, cannot be overstated. The older scalpel method of making an incision on the outside of the eyelid damages the support of the lower eyelid and can result in a sad eyed look or hound dog eyes.

I only use the transconjunctival blepharoplasty approach so that your beautiful lower eyelid shape will be preserved.

The benefits of using the laser are:

  • Less bleeding
  • Less bruising
  • Less swelling
  • Faster recovery
  • A more accurate result
  • Faster surgery-about 1/3 of the operative time required with scalpel blepharoplasty in my hands

Your Consultation

When we meet I will talk with you and ask you to explain to me the specific goals you hope to achieve. I will examine you and tell you my findings and describe the areas where I think improvement can be made. I will try to demonstrate on your eyes the appearance that I believe the arcus marginalis release and fat grafting will create on your eyes and face.

I will then recommend the procedure I feel is best for you. I will discuss the procedure, your recovery, and expectations and answer your questions. Photos of your face and eyes will be taken. You will be given an estimate or quote of the cost of the procedure. I do have financing plans available.

Pre OP

The pre operative visit is the time when we will sit down and clearly define your goals. We will discuss what you hope to achieve and what I believe I can achieve with an Arcus Marginalis Release and fat grafting.

You will also undergo a history and physical exam to make certain that you are healthy and have no medication allergies or contraindications’ to surgery. An EKG (electrocardiogram) may be done if you have a history of heart problems or have reached a certain age. You will also be given prescriptions for post operative medications.

You also will be asked to read and sign surgical consent forms which outline the risks, potential complications, limitations and expectations of eyelid surgery.

The Operation

The Arcus Marginalis Release and fat grafting takes about 90 minutes. If an upper blepharoplasty is also done to remove upper eyelid hooding, the procedure can take longer.

I prefer, and most of my patients choose, to go to sleep for the procedure. This provides for your comfort and also reduces the time of the operation.

Protective laser impermeable shields are placed over your eyes to prevent injury to your eye during surgery. Very special laser safety precautions are taken in the operating room.

Very experienced superb anesthesiologists will be taking care of you. Safety is our first concern. We use modern, very safe anesthesiology techniques, and take precautions to avoid nausea after surgery.

The Arcus Release and fat grafting is almost always done as an outpatient or day surgery. Ice packs are placed over your eyes immediately after surgery to help minimize bruising and swelling.

After you wake up you will be taken to the recovery room where a nurse will be taking care of you. The nurse monitors you, makes certain you are comfortable and checks your vision. You will spend 2-3 hours in recovery. After that, as soon as you are comfortable, able to drink and eat a bland food such as crackers or cookies, and able to go to the bathroom, you will be discharged. The nurse will escort you by wheel chair to your car.

We require that someone bring you to the surgery center and take you home, and that you have someone staying with you the first night after your surgery.

Post op- What to expect

My patients do not usually complain of pain following eyelid surgery. Initially you will feel your vision is obscured because I place protective ointment on the eye. For two weeks after surgery you will use this ointment at night when you go to bed. You will also be using soothing eye drops during the day for a few weeks after surgery.

The main recovery is the time for bruising and swelling to subside. Some patients have virtually no or minimal bruising due to the fact that I use the laser.

If bruising does occur you will want to wear sunglasses to cover the bruising. I also provide a mineral make up to cover the bruising. I do prescribe an herbal supplement called Arnica Montana to help prevent bruising.

Usually after 2 weeks you will be comfortable being seen in public and will be back to most normal activity. I ask you to wait 3 weeks before heavy weight lifting or aggressive work outs.

A Consultation with Dr Seckel

I can tell you a great deal more about the correction of Hollow Eyes and how it would work for you if I see you in person. Call me to set up a consultation or contact me by email. If you would like to email me your photos I can email you my thoughts about how I think an Arcus marginalis Release would work for you. For more information on eyelid rejuvenation visit my blogs or read my book.

I look forward to meeting you.

Dr Seckel

Boston, Massachusetts

Concord, Massachusetts

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