Lower blepharoplasty is a commonly performed procedure to improve the aesthetic of
the lower eyelid and upper midface. Combined fat pad transposition and fat grafting
has not been previously studied using three-dimensional (3D) analysis. The aim of
the study is to demonstrate the benefits of fat pad transposition with concomitant
autologous fat grafting in lower blepharoplasty and to determine quantitative volumetric
effects on the tear trough and lower periorbital region using VectraXT 3D imaging and analysis. A retrospective review was performed to identify patients
undergoing primary lower blepharoplasty with combined fat pad transposition and fat
grafting. The study time period was from September 2017 to March 2019 with a mean
6.5-month postoperative follow-up. This study was performed in a private practice
institution (Kovac Cosmetic Center, Oakbrook Terrace, IL). Nine subjects were enrolled
in the study with four males and five females. All subjects underwent lower blepharoplasty
with combined fat pad transposition and fat grafting without any additional procedures.
Preoperative and postoperative photographs were taken with the VectraXT 3D camera system and software. 3D photographs were then compared to assess the volume
changes in the periorbital region. The volume in the lower periorbital region was
assessed using 3D analysis. All subjects were found to have an increase in volume
in the periorbital region. There was a mean volume gain of 2.84 mL on the right and
2.87 mL on the left. There was no statistical difference among volume gains between
sides (p = 0.95). Combined fat pad transposition and autologous fat grafting is an effective
procedure for improving the tear trough deformity and periorbital area. The use of
3D volume assessment is able to accurately measure and quantify the volume changes
of the postoperative results.
Keywords
lower blepharoplasty - fat pad transposition - fat grafting - three-dimensional imaging
