title: Pedicled fat flap to increase lateral fullness in upper blepharoplasty.
abstract: 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.
authors.affiliation: El Paso Cosmetic Plastic Surgery Center, El Paso, TX 79912, USA. doctor@elpasoplasticsurgery.com
authors.forename: Sadri O
authors.initials: SO
authors.lastname: Sozer
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Agullo
authors.forename: Humberto
authors.initials: H
authors.lastname: Palladino
authors.forename: Phileemon E
authors.initials: PE
authors.lastname: Payne
authors.forename: Soumo
authors.initials: S
authors.lastname: Banerji
mesh_terms: 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