Correction of sunken upper eyelid with orbital fat transposition flap and dermofat graft

Lee, Won; Kwon, Soon-Beom; Oh, Suyeon; Yang, Eun‐Jung

doi:10.1016/j.bjps.2017.05.003

Cited by 29 publications

(40 citation statements)

References 12 publications

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“…The orbital fat pad is a pedicled adipose tissue flap with an intact and reliable vascular supply, which is advantageous over other fat grafts. 3 Long-term correction can be maintained if a secure tension-free fixation of the fat pad has been achieved. It is soft and pliable enough to form a smooth and natural contour for the upper eyelid.…”

Section: Discussionmentioning

confidence: 99%

“…The important features of beautiful and youthful eyes consist of a sharp, well-defined supratarsal fold and appropriate fullness of upper eyelid tissue. 3 The hollowness in the upper eyelid is a cosmetic problem that results in a tired and senile appearance. 4 It can be caused by tissue volume depletion in the upper eyelid due to multiple factors, including aging, massive weight loss, trauma, surgery, and others.…”

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confidence: 99%

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Sunken Upper Eyelid Deformity Correction by Orbital Fat Pad Repositioning and Orbicularis Oculi Muscle Folding in Blepharoplasty

Lin²,

Li³

2023

Journal of Craniofacial Surgery

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Background: Sunken upper eyelid deformity results in an aged and unnatural appearance and is common among Asians along with the single eyelid. The upper eyelid volume restoration is as important as the creation of a supratarsal fold for patients with sunken eyelids. In the present study, the combination of orbital fat pad repositioning and orbicularis oculi muscle flap folding was established to correct the upper eyelid depression during blepharoplasty. Methods: A retrospective study was conducted on patients who underwent the orbital fat pad repositioning and orbicularis oculi muscle flap folding to correct the upper eyelid depression between July 2020 and October 2021. The preoperative and postoperative sunken depths were calculated and compared, and overall patient satisfaction was performed to evaluate the operation efficiency. Results: There were 40 patients, including 39 females and 1 male, who underwent surgery with an average age of 25.4 years. During the mean follow-up period of 12.7 months, the sunken depth improved from 3.2 mm preoperatively to 1.5 mm postoperatively with a statistical significance. Satisfactory results were achieved without major complication. Conclusions: For patients with mild to moderate sunken upper eyelids, the combination of orbital fat pad repositioning and orbicularis oculi muscle folding has been proved efficient and consistent to restore the upper eyelid volume and helpful to build esthetic double eyelids.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Sunken Upper Eyelid Deformity Correction by Orbital Fat Pad Repositioning and Orbicularis Oculi Muscle Folding in Blepharoplasty

Lin²,

Li³

2023

Journal of Craniofacial Surgery

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“…At present, the methods of restoring upper eyelid volume mainly include tissue repositioning (eyebrow fat pad metastasis, orbital septum fat resetting, upper eyelid levator aponeurosis folding), injection and filling (autogenous tissue, synthetic preparation), and combination of the 2. 5 Clinical soft tissue fillers such as hyaluronic acid and collagen can effectively restore upper eyelid volume and improve skin quality. However, the high cost, short duration, and risk of allergies and other complications hamper its widespread use.…”

Section: Discussionmentioning

confidence: 99%

Orbital Septum Fat Flap Transfer for Upper Eyelid Depression

Shan

Ding

Bai

et al. 2021

Journal of Craniofacial Surgery

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Background: Sunken upper eyelid makes people's eyes look gaunt and aging. At present, more and more people are paying attention to eye rejuvenation, and more and more people are asking for correction of sunken upper eyelid. Orbital septum fat plays an important role in the display of eye contour. Therefore, the position of orbital septum fat can be adjusted surgically to improve the upper eyelid depression.Objective: This article discusses the clinical effect of orbital septum fat flap transfer in the upper eyelid depression of mild to moderate. Methods: Thirty patients with single eyelid depression in our hospital from April to September 2020 were selected. After blepharoplasty, the orbital septum fat was fully released and the lateral orbital fat transfer was fixed to the mid-medial upper eyelid depression. Results: After the operation, 29 patients were satisfied with the results, with good incision healing, bilateral basic symmetry no obvious scar, and negative effect of non-convex and concave eyelid inequality. One patient did not achieve the expected results and was treated with a second autologous fat filling. Conclusions: For patients with mild to moderate sunken upper eyelid, orbital septal fat flap metastasis during blepharoplasty has not only good effect, natural appearance, and smooth upper eyelid skin, but also only 1 incision for upper eyelid formation, which has high acceptance and satisfaction of patients and can be widely used in clinical practice.

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“…With aging, sunken upper eyelids can develop due to skin laxity and atrophy of orbital fat and subcutaneous tissue. In addition, with the increasing num ber of blepharoplasty procedures in the Asian population, sunken upper eyelids are becoming increasingly common because the cur rent technique for blepharoplasty in Asian patients involves remov ing excess orbital fat to create a double fold and reduce bulging in the supratarsal area [14].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a de-epithelialized orbicularis oculi musculocutaneous flap for subbrow blepharoplasty

Kim

Ahn

Suh

et al. 2019

Arch Aesthetic Plast Surg

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Background Subbrow blepharoplasty (SBB) has advantages over traditional blepharoplasty in that it results in more natural-looking creases and contours and is more effective for lateral periorbital rejuvenation. However, in older patients with sunken upper eyelid, this procedure might make the superior eyelid sulcus appear worse because the thicker upper eyelid tissue in the subbrow area is replaced by thinner tissue. To overcome this limitation, we developed a de-epithelialized musculocutaneous flap for SBB. Methods From August 2016 to January 2018, 13 patients with sunken upper eyelid deformity underwent SBB. For each of these patients, a typical SBB incision was made, but the tissue usually removed in SBB was dissected as a flap based on the branch of the ophthalmic vessel. After elevation, the flap was transposed or folded to correct the sunken deformity. The results were assessed by the patients themselves and by three plastic surgeons at 6 months postoperatively. Results The mean age of the patients was 63 years (range, 47-81 years). There were no postoperative complications related to wound dehiscence, hypertrophic scarring, or sensory changes. All patients and plastic surgeons provided scores indicating good to excellent results and were satisfied with the cosmetic outcomes. All patients reported improved functional visual acuity after surgery. Conclusions Our technique is simple and effectively addresses both sunken upper eyelid deformity and dermatochalasis. Unlike fat or dermofat grafting, our new technique does not require an additional donor site, and it is more reliable in terms of vascularity.

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Correction of sunken upper eyelid with orbital fat transposition flap and dermofat graft

Cited by 29 publications

References 12 publications

Sunken Upper Eyelid Deformity Correction by Orbital Fat Pad Repositioning and Orbicularis Oculi Muscle Folding in Blepharoplasty

Sunken Upper Eyelid Deformity Correction by Orbital Fat Pad Repositioning and Orbicularis Oculi Muscle Folding in Blepharoplasty

Orbital Septum Fat Flap Transfer for Upper Eyelid Depression

Feasibility of a de-epithelialized orbicularis oculi musculocutaneous flap for subbrow blepharoplasty

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