Lower blepharoplasty with capsulopalpebral fascia hernia repair for palpebral bags: a long-term prospective study.
BACKGROUND
In December of 1998, the authors published a prospective study in Plastic and Reconstructive Surgery (102: 2459, 1998) comparing standard lower blepharoplasty with lipectomy on one side and fat-preserving capsulopalpebral fascia hernia repair on the contralateral side; comparable aesthetic outcomes were demonstrated after 6 months of follow-up. In the present study, the authors report their findings on the original patient cohort with an average follow-up of 11.3 years.


METHODS
From 1991 to 2007, 26 patients were identified who had previously undergone lower blepharoplasty for palpebral bags, using fat removal on one side and fat preservation on the contralateral side. These patients were evaluated, and the incidence and locations of palpebral bag recurrence, lower lid hollowing, lid malposition, and eyelid dysmobility were documented.


RESULTS
The overall recurrence rate of palpebral bags under the eyes following standard fat resection (30.8 percent) was significantly higher than for eyes following capsulopalpebral fascia hernia repair (7.7 percent) (p = 0.043). Recurrences of fat herniation, of generally less significance than the original preoperative status, were not found in any of the lower eyelid compartments in the former group, and only in the lateral compartment in the latter.


CONCLUSIONS
At long-term follow-up, fat-preserving capsulopalpebral fascia repair for palpebral bags demonstrates superiority to standard blepharoplasty with lipectomy, with significantly lower recurrence of palpebral bags. In a small percentage of patients undergoing capsulopalpebral fascia hernia repair, limited fat resection in selected patients may eliminate hernia recurrence.
Parsa
Alan A
AA
Trenton, N.J.; Honolulu, Hawaii; and New York, N.Y. From the Seton Hall University School of Graduate Medical Education, St. Francis Medical Center; Department of Surgery, John A. Burns School of Medicine, University of Hawaii; and Department of Ophthalmology, New York University School of Medicine.
Lye
Kevin D
KD
Radcliffe
Nathan
N
Parsa
Fereydoun Don
FD
D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000379:methods; D005141:Eyelid Diseases / Q000601:surgery*; D005205:Fascia; D005260:Female; D005500:Follow-Up Studies; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors