Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지

Correction of the Tear Trough Using Orbital Fat Graft from the Lower Lid

제거한 하안검 지방의 이식을 이용한 눈물받이 고랑의 교정

  • You, Young Cheun (Department of Plastic and Reconstructive Surgery, College of Medicine, Kyunghee University) ;
  • Lim, Dae Won (Department of Plastic and Reconstructive Surgery, College of Medicine, Kyunghee University) ;
  • Yang, Won Yong (Department of Plastic and Reconstructive Surgery, College of Medicine, Kyunghee University) ;
  • Park, Jun (Department of Plastic and Reconstructive Surgery, College of Medicine, Kyunghee University)
  • 유영천 (경희대학교 의과대학 성형외과학교실) ;
  • 임대원 (경희대학교 의과대학 성형외과학교실) ;
  • 양원용 (경희대학교 의과대학 성형외과학교실) ;
  • 박준 (경희대학교 의과대학 성형외과학교실)
  • Received : 2006.02.24
  • Published : 2006.05.10
Download PDF
⟨ Previous Next ⟩

Abstract

Lower palpebral bags and tear trough grooves are the common signs of aging. Weakness of the orbital septum, atrophy of the orbicularis oculi muscle, slackness and laxity of the lower lid skin are the main causes of these aging changes. Tear trough groove with skeletonization of the lower orbital rim can not be corrected easily by the conventional lower blepharoplasty, but the augmentation of the volume, can be an effective method. Lower lids provide a well vascularized recipient site, which is vital for proper grafting of fat to occur. We treated tear trough groove with free fat graft of surgically removed orbital fat. Surgical excision of the fat pad and septal reinforcement with free fat graft below the levator labii superioris alaeque nasi muscle were performed to correct tear trough groove. This technique was performed in 29 consecutive individuals from October, 2001 to January, 2005. Palpebral bags and tear trough groove were corrected concomitantly and obtained a youthful attractive midface with no secondary hollowness of lower lid and irregularity. The overall results obtained were satisfactory without any complications. Recurrence of tear trough deformity due to grafted fat absorption was not noted during the 7 months of the follow-up period. The authors conclude that the procedure is safe and effective in selected patients.

Keywords

References

  1. De la Plaza, Arroyo JM: A new technique for the treatment of palpebral bags. Plast Reconstr Surg 81: 677, 1988 https://doi.org/10.1097/00006534-198805000-00005
  2. Barton FE Jr, Ha R, Awada M: Fat extrusion and septal reset in patients with the tear trough triad: A critical appraisal. Plast Reconstr Surg 113: 2115, 2004 https://doi.org/10.1097/01.PRS.0000122409.00716.34
  3. Lee TJ, Yoon SY: Fat preservation lower blepharoplasty: septal draping over inferior orbital rim. J Korean Soc Plast Reconstr Surg 28: 100, 2001
  4. Goldberg RA: Transconjunctival orbital fat repositioning: transposition of orbital fat pedicles into a subperiosteal pocket. Plast Reconstr Surg 105: 743, 2000 https://doi.org/10.1097/00006534-200002000-00044
  5. Baik BS, Chung KH, Chung JY, Park JW, Cho BC: The treatment of palpebral bags by repositioning of orbital fat into a subperiosteal pocket. J Korean Soc Aesth Plast Surg 8: 99, 2002
  6. Loeb R: Fat pad sliding and fat grafting for leveling lid depressions. Clin Plast Surg 8: 757, 1981
  7. Hamra ST: Arcus margina1is release and orbital fat preservation in midface rejuvenation. Plast Reconstr Surg 96: 354, 1995 https://doi.org/10.1097/00006534-199508000-00014
  8. Hester TR Jr, Codner MA, McCord CD, Nahai F, Giannopoulos A: Evolution of technique of the direct transblepharoplasty approach for the correction of lower lid and midfacial aging: Maximizing results and minimizing complications in a 5-year experience. Plast Reconstr Surg 105: 393, 2000 https://doi.org/10.1097/00006534-200001000-00063
  9. Mendelson BC: Herniated fat and the orbital septum of the lower lid. Clin Plast Surg 20: 323, 1993
  10. Hamra ST: Repositioning the orbicularis oculi muscle in the composite rhytidectomy. Plast Reconstr Surg 90: 14, 1992 https://doi.org/10.1097/00006534-199207000-00002
  11. Camirand A, Doncet J, Harris J: Anatomy, pathophysiology, and prevention of senile enophthalmia and associated herniated lower eyelid fat pads. Plast Reconstr Surg 100: 1535, 1997
  12. Sensoz 0, Unlu RE, Percin A, Baran CN, Celebioglu S, Ortak T: Septo-orbitoperiostoplasty for the treatment of palpebral bags: a 10 year experience. Plast Reconstr Surg 101: 1657, 1998 https://doi.org/10.1097/00006534-199805000-00037
  13. Huang T: Reduction of lower palpebral bulge by plicating attenuated orbital septa: A technical modification in cosmetic blepharoplasty. Plast Reconstr Surg 105: 2552, 2000 https://doi.org/10.1097/00006534-200006000-00040
  14. Jin ES, Jung JH, Kim YH, Sun H: The correction of lower palpebral bulge & tear trough groove by repositioning of orbicularis oculi muscle, orbital septum & orbital fat. J Korean Soc Plast Reconstr Surg 32: 304, 2005
  15. Choo PH, Carter SR, Seiff SR: Lower eyelid volume augmentation with fat pearl grafting. Plast Reconstr Surg 102: 1716, 1998 https://doi.org/10.1097/00006534-199810000-00063