Pedicled fat flap to increase lateral fullness in upper blepharoplasty.
BACKGROUND
The eyelid of a young person can be distinguished by the lateral fullness of the upper eyelid. With aging, lateral fullness decreases. Volume restoration in the periorbital area has been previously addressed by fat draping and grafting. More recently, techniques for regaining lateral fullness of the upper eyelid have focused on fat grafting, although effective graft take, reabsorption, and irregularities have been a concern. To address these issues, the concept of pedicled fat draping in the upper eyelid was explored.


METHODS
In a retrospective study from June 2006 to August 2008, 31 patients underwent upper blepharoplasty with augmentation of the lateral fullness with a pedicled fat flap from the central fat pad. The fat from the central compartment was elevated, dissected, and then transposed to the lateral upper eyelid below the orbicularis muscle.


RESULTS
All patients were women ranging in age from 43 to 68 years. Pre- and postoperative picture comparison demonstrated a more youthful appearance with increased lateral fullness of the upper eyelids. There were no cases of fat necrosis encountered. Increased volume remained stable over an average of one-year follow-up. No complications were recorded.


CONCLUSIONS
Transposing a pedicled fat pad from the central compartment laterally has proven to be an effective technique for achieving predictable upper lateral eyelid fullness and thus achieving a long-lasting, more youthful appearance.
Sozer
Sadri O
SO
El Paso Cosmetic Plastic Surgery Center, El Paso, TX 79912, USA. doctor@elpasoplasticsurgery.com
Agullo
Francisco J
FJ
Palladino
Humberto
H
Payne
Phileemon E
PE
Banerji
Soumo
S
D000273:Adipose Tissue / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty / Q000379:methods*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome