Download PDF
Facial Plast Surg 2013; 29(01): 046-057
DOI: 10.1055/s-0033-1333842
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Periorbital Fat Grafting

Guy G. Massry
1   Beverly Hills Ophthalmic Plastic and Reconstructive Surgery, Beverly Hills, California
2   Department of Surgery, Division of Opthalmology, Cedars-Sinai Medical Center, Los Angeles, California
,
Babak Azizzadeh
3   Department of Facial Plastic & Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, California
4   Division of Head & Neck Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, Beverly Hills, California
› Author Affiliations
Further Information

Publication History

Publication Date:
20 February 2013 (online)

    Permissions and Reprints

Abstract

Periorbital aging is a multifactorial process involving volume loss (bone and soft tissue), tissue decent, and cutaneous degenerative changes. Traditional approaches to surgery on this area of the face have been subtractive in nature, focusing on excision of skin, muscle, and fat. This has frequently led to a gaunt or hollowed postoperative appearance. Contemporary aesthetic eyelid and periorbital rejuvenation has undergone a paradigm shift from an excisionally based surgical approach to one that prioritizes volume preservation and/or augmentation. The development of fat grafting to the eyelids and periorbita has given the eyelid surgeon a viable surgical alternative to prevent postoperative volume depletion, maintain the smooth transition of the lower eyelid to the cheek, and aid in restoring the youthful appearance desired after surgery. This article will focus of periorbital fat grafting and touch upon fat preservation techniques as primary restorative procedures or as surgical adjuncts

Keywords

eyelid fat grafting - nasojugal groove - tear trough - orbitomalar groove - eyelid–cheek interface - eyelid–cheek junction - fat repositioning
 

  • References

  • 1 Massry GG. Nasal fat preservation in upper eyelid blepharoplasty. Ophthal Plast Reconstr Surg 2011; 27: 352-355
    CrossrefPubMedGoogle Scholar
  • 2 Katzen LB. The history of cosmetic blepharoplasty. Adv Ophthalmic Plast Reconstr Surg 1986; 5: 89-96
    PubMedGoogle Scholar
  • 3 Reidy JP. Swellings of eyelids. Br J Plast Surg 1960; 13: 256-267
    CrossrefPubMedGoogle Scholar
  • 4 Neuhaus R, Baylis H. Complications of lower eyelid blepharoplasty. In: Putterman AM, , ed. Cosmetic Oculoplastic Surgery. New York, NY: GrundStratton; 1982
    Google Scholar
  • 5 McGraw BL, Adamson PA. Postblepharoplasty ectropion. Prevention and management. Arch Otolaryngol Head Neck Surg 1991; 117: 852-856
    CrossrefPubMedGoogle Scholar
  • 6 Taban M, Douglas R, Li T , et al. Efficacy of “thick” acellular human dermis (alloderm) for lower eyelid retraction. Arch Facial Plast Surg 2005; 7: 38-44
    CrossrefPubMedGoogle Scholar
  • 7 Edgerton Jr MT. Causes and prevention of lower lid ectropion following blepharoplasty. Plast Reconstr Surg 1972; 49: 367-373
    PubMedGoogle Scholar
  • 8 Webster RC, Davidson TM, Reardon EJ, Smith RC. Suspending sutures in blepharoplasty. Arch Otolaryngol 1979; 105: 601-604
    CrossrefPubMedGoogle Scholar
  • 9 Tenzel RR. Cosmetic blepharoplasty. In: Soll DB, , ed. Management of Complications in Ophthalmic Plastic Surgery. Birmingham, AL: Aesculapiuus; 1976: 119-131
    Google Scholar
  • 10 Kantzen LB, Tenzel RR. Canthal laxity and eyelid malpositions. Adv Ophthalmol Plast Reconstr Surg. 1983; 2: 229-243
    PubMedGoogle Scholar
  • 11 Anderson RL, Gordy DD. The tarsal strip procedure. Arch Ophthalmol 1979; 97: 2192-2196
    CrossrefPubMedGoogle Scholar
  • 12 Bourguet J : Les hernies graisseuses de I'orbite Notre treitement chirugical. Bull Acad Med (Paris) 1924; 92 (3 ser) 1270
    PubMedGoogle Scholar
  • 13 Tomlinson FB, Hovey LM. Transconjunctival lower lid blepharoplasty for removal of fat. Plast Reconstr Surg 1975; 56: 314-318
    PubMedGoogle Scholar
  • 14 Baylis HI, Long JA, Groth MJ. Transconjunctival lower eyelid blepharoplasty. Technique and complications. Ophthalmology 1989; 96: 1027-1032
    CrossrefPubMedGoogle Scholar
  • 15 Kamer FM, Mikaelian AJ. Preexcision blepharoplasty. Arch Otolaryngol Head Neck Surg 1991; 117: 995-999 , discussion 1000
    CrossrefPubMedGoogle Scholar
  • 16 Lambros VS. The dynamics of facial aging. Paper presented at: the Annual Meeting of the American Society for Aesthetic Plastic Surgery; April 27 to May 3, 2002; Las Vegas, NV
    PubMedGoogle Scholar
  • 17 Donath AS, Glasgold RA, Glasgold MJ. Volume loss versus gravity: new concepts in facial aging. Curr Opin Otolaryngol Head Neck Surg 2007; 15: 238-243
    CrossrefPubMedGoogle Scholar
  • 18 Lam S, Glasgold M, Glasgold R. Complementary Fat Grafting. Philadelphia, PA: Lippincott Williams & Wilkins; 2007
    Google Scholar
  • 19 Massry GG, Hartstein MA. The lift and fill lower blepahroplasty. Ophthal Plast Reconstr Surg 2012; ; In press
    PubMedGoogle Scholar
  • 20 Massry GG. Comprehensive lower eyelid rejuvenation. Facial Plast Surg 2010; 26: 209-221
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Glassgold RA, Lam SM, Glassgold MJ. Periorbital fat grafting. In Massry GG, Murphy M, Azizzadeh B, , eds. Master Techniques in Blepharoplasty and Periorbital Rejuvenation. New York, NY: Springer; 2011: 259-272
    CrossrefGoogle Scholar
  • 22 Ramirez OM. Midface and lower eyelid rejuvenation. In: Massry GG, Murphy M, Azizzadeh B, , eds. Master Techniques in Blepharoplasty and Periorbital Rejuvenation. New York, NY: Springer; 2011: 225-241
    CrossrefGoogle Scholar
  • 23 Korn BS, Kikkawa DO, Hicok KC. Identification and characterization of adult stem cells from human orbital adipose tissue. Ophthal Plast Reconstr Surg 2009; 25: 27-32
    CrossrefPubMedGoogle Scholar
  • 24 Oh SR, Chokthaweesak W, Annunziata CC, Priel A, Korn BS, Kikkawa DO. Analysis of eyelid fat pad changes with aging. Ophthal Plast Reconstr Surg 2011; 27: 348-351
    CrossrefPubMedGoogle Scholar
  • 25 Donath AS, Glasgold RA, Meier J, Glasgold MJ. Quantitative evaluation of volume augmentation in the tear trough with a hyaluronic acid-based filler: a three-dimensional analysis. Plast Reconstr Surg 2010; 125: 1515-1522
    CrossrefPubMedGoogle Scholar
  • 26 Morley AM, Malhotra R. Use of hyaluronic acid filler for tear-trough rejuvenation as an alternative to lower eyelid surgery. Ophthal Plast Reconstr Surg 2011; 27: 69-73
    CrossrefPubMedGoogle Scholar
  • 27 Goldberg RA, Fiaschetti D. Filling the periorbital hollows with hyaluronic acid gel: initial experience with 244 injections. Ophthal Plast Reconstr Surg 2006; 22: 335-341 , discussion 341–343
    CrossrefPubMedGoogle Scholar
  • 28 Morley AM, Taban M, Malhotra R, Goldberg RA. Use of hyaluronic acid gel for upper eyelid filling and contouring. Ophthal Plast Reconstr Surg 2009; 25: 440-444
    CrossrefPubMedGoogle Scholar
  • 29 Glasgold RA, Glasgold MJ, Lam SM. Complications following fat transfer. Oral Maxillofac Surg Clin North Am 2009; 21: 53-58 , vi
    CrossrefPubMedGoogle Scholar
  • 30 Taban M, Lee S, Hoenig JA , et al. Postoperative wound modulation in aesthetic and eyelid periorbital surgery. In: Massry GG, Murphy M, Azizzadeh B, , eds. Master Techniques in Blepharoplasty and Periorbital Rejuvenation. New York, NY: Springer; 2011: 307-312
    CrossrefGoogle Scholar
  • 31 Loeb R. Fat pad sliding and fat grafting for leveling lid depressions. Clin Plast Surg 1981; 8: 757-776
    CrossrefPubMedGoogle Scholar
  • 32 Hamra ST. Arcus marginalis release and orbital fat repositioning in midface rejuvenation. Plast Reconstr Surg 1995; 92: 354-362
    PubMedGoogle Scholar
  • 33 Hamra ST. The role of orbital fat preservation in facial aesthetic surgery. A new concept. Clin Plast Surg 1996; 23: 17-28
    PubMedGoogle Scholar
  • 34 Goldberg RA. Transconjunctival orbital fat repositioning: transposition of orbital fat pedicles into a subperiosteal pocket. Plast Reconstr Surg 2000; 105: 743-748 , discussion 749–751
    CrossrefPubMedGoogle Scholar