Volumetric upper blepharoplasty, which combines fat grafting with the orbicularis oculi muscle imbrication, was associated with improved contour in a cohort of women with hollow upper eyelids.
Researchers suggested that periorbital volume loss is associated with a “shadow frame” and suggested that disparity in filling techniques created the need for a novel approach. The retrospective analysis included 32 women who underwent fat grafting to treat hollow upper eyelids. Researchers conducted a review of photographs of the women in preoperative and postoperative settings. Assessed outcomes included upper eyelid ratios at the medial and lateral corneal limbus, along with lateral contour modifications.
In the preoperative evaluation, 20 eyelids had an inner shadow, or A-pattern. Forty-four had a complete extension of the hollow, or C-pattern. Mild blepharoptosis was reported in three patients, while a history of upper blepharoplasty was reported in eight patients.
A mean grafting volume of 0.4 cc was observed in the deep plane, while this volume was 2.8 cc in the superficial plane. Six patients underwent only fat grafting. In this group, improvements were seen in all ratios, with the A-pattern deformity corrected.
Twenty-six patients underwent volumetric upper blepharoplasty combining fat grafting in two levels. These patients also experienced orbicularis oculi muscle imbrication as part of that procedure, which the researchers noted corrected each inverted ratio.
Every approach was successful in changing patients with a concave pattern to a convex pattern on the lateral view.
“Synergy between fat grafting and orbicularis imbrication proved adequate to restore the lateral convex contour and return youthful proportions to the hollow upper eyelids,” the researchers concluded. – by Rob Volansky
Disclosures: Ramil reports no relevant financial disclosures. Please see the study for the full list of all other authors’ relevant financial disclosures.