결막절개를 제거통한 아래 눈꺼풀 부위의 미세자가지방이식편의

Removal of Microfat Graft in Lower Eyelid with Transconjunctival Approach

  • 신종인 (조앤신 성형외과) ;
  • 장정우 (한양대학교 의과대학 성형외과학교실) ;
  • 김창연 (한양대학교 의과대학 성형외과학교실) ;
  • 김연환 (한양대학교 의과대학 성형외과학교실)
  • Shin, Jong-In (Jo N Shin Plastic Surgery Clinic) ;
  • Chang, Jung-Woo (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Kim, Chang-Yeon (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Kim, Youn-Hwan (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University)
  • 투고 : 2010.08.15
  • 심사 : 2010.10.18
  • 발행 : 2011.01.10

초록

Purpose: Microfat graft is a common procedure for correcting tear trough deformity and dark circle. Because the tissue in this area is very thin, the grafted fat, sometimes, induces palpable lumps and uneven skin contour. When it happens, the surgical removal of the grafted fat is often needed. The authors made attempt of transconjunctival approach for removal, and this made infraorbital fat repositioning possible at the same time. Methods: 15 female patients with history of microfat graft on lower eyelid, got operation for the grafted fat removal with transconjunctival approach from April of 2009 to July of 2010. The dissection was performed in accordance with infraorbital fat repositioning surgery. Through the transconjunctival incision, knotted fat on orbital septum and orbicularis oculi muscle was removed without damage on skin. After grafted fat removal, subperiosteal space was made 1~2 mm below the inferior orbital rim by elevating periosteum. With preserving orbital septum, infraorbital fat was repositioned and anchored to subperiosteal space. Finally, transconjunctival incision was closed with absorbable suture material. Results: 14 patients in the study showed satisfactory results. The problems like uneven skin contour and knotted fat mass, were all solved. In only one patient, incomplete correction was observed, as bulging on her right lower eyelid still remained. One patient complained of transient numbness on lower eyelid, but there was no specific complication other than this. Conclusion: The authors attempted the method of transconjunctival approach to remove former grafted fat in lower eyelid and reposition infraorbital fat simultaneously. Since the study brought great results, the method would be helpful to patients and surgeons.

키워드

참고문헌

  1. Shenaq SM, Kim JYS: Repair and grafting of peripheral nerve. In Mathes SJ, Hentz VR (eds): Plastic Surgery, 2nd ed, Philadelphia, Saunders, 2006, p 719
  2. Lee YH: Facelift. In Lee YH (ed): Aesthetic Plastic Surgery. 1st ed, Seoul, Kunja Publishing Inc., 1998, p 260
  3. Coleman SR: Structural fat grafting. 1st ed, St. Louis, Quality Medical Publishing Inc., 2004, p 313
  4. Haddock NT, Saadeh PB, Boutros S, Thorne CH: The tear trough and lid/cheek junction: anatomy and implications for surgical correction. Plast Reconstr Surg 123: 1332, 2009 https://doi.org/10.1097/PRS.0b013e31819f2b36
  5. Coleman SR: Structural fat grafting. 1st ed, St. Louis, Quality Medical Publishing Inc., 2004, p 83
  6. Boehm KA, Hester TR Jr., Codner MA: Fat grafting in the periorbital region. In McCord CD Jr., Codner MA (eds): Eyelid and Periorbital Surgery. 1st ed, St. Louis, Quality Medical Publishing Inc., 2008, p 393
  7. Yousif NJ, Sonderman P, Dzwierzynski WW, Larson DL: Anatomic considerations in transconjunctival blepharoplasty. Plast Reconstr Surg 96: 1271, 1995 https://doi.org/10.1097/00006534-199511000-00005
  8. Kawamoto HK, Bradley JP: The tear "trough" procedure: transconjunctival repositioning of orbital unipedicled fat. Plast Reconstr Surg 112: 1903, 2003 https://doi.org/10.1097/01.PRS.0000091238.72843.7E
  9. 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