What does the procedure consist of?

The procedure is performed under local anesthesia and/or sedation, so it is not painful or uncomfortable for the patient. A sufficient amount of adipose tissue is extracted (from the abdomen, love handles, or any localized adipose accumulation desired by the patient), processed by centrifugation according to Dr. Coleman’s protocol, and then infiltrated into the desired area. The entire process takes approximately 45-50 minutes to complete.

Subsequently, the patient has to rest for 5-6 days to achieve an adequate attachment of the adipose tissue, and finally in 1 month and a half the final result (the attachment of the grafts) is evaluated.

It is usual to perform a touch-up to achieve the optimal result, although as we have already mentioned, once the adipose tissue has taken hold, it is not necessary to repeat the infiltration.


The filling of dark circles under the eyes and malar area is one of the most requested by our patients.

That look of tiredness, dark circles under the eyes, darkening of the lower eyelid… is very characteristic of the active woman who today manages to meet her thousand commitments to work, study, family and social commitments.

The procedure of filling dark circles under the eyes and/or the malar area with the patient’s own adipose tissue is a procedure that is becoming more and more fashionable every day and it is no wonder, since it is an excellent treatment to improve the aging of the periorbital area. It must be remembered that it is necessary to make an anatomical study of each patient and a diagnosis prior to the procedure, since it is essential to make a good selection of the patient.

Within the specialty of plastic surgery, one of the basic objectives is the correction of deformities, and one of the most commonly used tools for this purpose are fillers.

There are an infinite number of filler materials (synthetic, biological, autologous…), and although there is still no universal consensus on the ideal filler material, there are certain points on the properties of the ideal filler on which the different authors agree.



  • The filler material must be biocompatible, with total integration in the recipient, without degeneration of the filler material or alterations in the recipient organism.
  • They must not be toxic or produce cancer or other alterations in the receptor.
  • They must be immunologically neutral, so as not to trigger allergies or exacerbation of autoimmune diseases such as lupus, rheumatoid arthritis, scleroderma, etc.
  • They must be similar to the fabric we want to replace or simulate.
  • They must be permanent.
  • They must be easy to remove after injection, if the patient needs it or it is necessary for any other reason.
  • The filling material should not distort the diagnosis of other pathologic processes, both by physical examination and imaging tests.
  • Preferably from the same patient.

For which patients is the facial filler intended?

Patients of any sex and age who present with tear through deformity, either in the form of sagging or dark coloration of the dark circles under the eyes. The bluish discoloration of dark circles under the eyes is significantly improved with this procedure.

However, patients with large preseptal fat herniation (commonly referred to as “lower eyelid fat pads”), excessive laxity or severe lower eyelid elastosis are not good candidates for this procedure. On the other hand, in cases of skin hyperpigmentation, there may be no improvement in coloration after the procedure.


What does the lipofilling procedure look for?

Restore the natural and aesthetically considered “attractive” shape to the lower eyelid: with a smooth and continuous transition between the preseptal and orbicular portions of the eyelid, with no definite transition point or groove between these areas, and restore the appearance of fullness to the malar prominences.

What types of filling materials are available, and which is the most recommended?

One of the most well-known and widely used filler materials today is hyaluronic acid, a resorbable and biocompatible material (so it will not cause foreign body reactions or rejection) that is used in multiple body areas. It has a reabsorption rate varying from 6 months to a year (sometimes it can last up to 2 years, if the appropriate touch-ups are made) One of its disadvantages is the high price of the vials of this product, which makes it preferably applied in areas that need to be treated. low volume infiltrations.

Another filler material is the patient’s own adipose tissue, which through a standardized technique is extracted and processed, isolating the adipose cells to later infiltrate them for repair and/or remodeling of certain body areas. The advantages of this type of filler are the following: it is an autologous material (the patient’s own), it is totally biocompatible, safe, and once the graft is stabilized, stable over time. This technique allows us to prepare adipose tissue grafts of large size or volume, so it is generally more economical.

One of the strengths of adipose tissue filler is that once the treatment is completed, the deposited adipose tissue “attaches” to the receptor bed (in this case, the dark circles under the eyes) and is not reabsorbed, so it is not necessary to repeat the procedure periodically, as is the case with resorbable fillers..

Our choice for the treatment of dark circles under the eyes is the infiltration of adipose tissue grafts.For an optimal result, two areas should normally be treated: the tear through sagging itself, and the malar area, which will support the lower eyelid in the long term, preventing the deformity from reappearing. This implies that a considerable volume of filler material is used to perform the entire treatment.

However, it is necessary to analyze each case and patient individually.

What is the tear through deformity?

One of the most common problems that patients tell us, within the aesthetic surgery practice, is the lack of a good quality of life for the patient.the presence of dark circles under the eyes, a “tear through” or “tear trough” with a sunken lookThis is a dark coloration of the lower eyelid and results in a tired or fatigued appearance (even if the patient has had adequate rest).

This deformity is caused by the anatomical nature of the orbital system, is due to the existence of lower eyelid ligaments, attached to the periorbital margin, which remain more or less tense over the years, as opposed to the rest of the eyelid and malar tissues, which become lax and increasingly weaker as we age. In this way, the smooth transition between the lower eyelid structures and the malar area is lost.


Which type of facial filler meets virtually all of these premises?

The patient’s own adipose tissue, properly treated and processed, is the filler that comes closest to the definition of “ideal filler material”.

Its use has been documented since the end of the 19th century to repair traumatic or oncological sequelae of the whole body, however, in recent years, already in the 21st century, is when the use of adipose tissue grafts has reached its splendor, with the refinement of extraction, processing and infiltration techniques.


Facial infiltrations with adipose tissue

Particularly in facial aesthetic surgery and medicine, this type of infiltration is used for allows us to correct a wide variety of defects: dark circles under the eyes, tear through deformity or tear trough, fill the malar area, jaw area, chin, treat barcode wrinkles, fill lips, nasolabial fold, wrinkles in general?

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