Download PDF
Facial Plast Surg 2020; 36(04): 478-483
DOI: 10.1055/s-0040-1713790
Original Research

Lower Blepharoplasty Three-Dimensional Volume Assessment after Fat Pad Transposition and Concomitant Fat Grafting

Robert T. Cristel
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, University of Illinois at Chicago, Chicago, Illinois
,
Benjamin P. Caughlin
2   Division of Facial Plastic and Reconstructive Surgery, Kovac Cosmetic Center, Oakbrook Terrace, Illinois
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

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


Publication History

Article published online:
06 July 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 

  • References

  • 1 Jacono AA, Malone MH. Extended submuscular blepharoplasty with orbitomalar ligament release and orbital fat repositioning. JAMA Facial Plast Surg 2017; 19 (01) 72-73
    CrossrefPubMedGoogle Scholar
  • 2 Murri M, Hamill EB, Hauck MJ, Marx DP. An update on lower lid blepharoplasty. Semin Plast Surg 2017; 31 (01) 46-50
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Miller TR. Long-term 3-dimensional volume assessment after fat repositioning lower blepharoplasty. JAMA Facial Plast Surg 2016; 18 (02) 108-113
    CrossrefPubMedGoogle Scholar
  • 4 Meier JD, Glasgold RA, Glasgold MJ. Autologous fat grafting: long-term evidence of its efficacy in midfacial rejuvenation. Arch Facial Plast Surg 2009; 11 (01) 24-28
    CrossrefPubMedGoogle Scholar
  • 5 Kim HS, Choi CW, Kim BR, Youn SW. Effectiveness of transconjunctival fat removal and resected fat grafting for lower eye bag and tear trough deformity. JAMA Facial Plast Surg 2019; 21 (02) 118-124
    CrossrefPubMedGoogle Scholar
  • 6 Kim J, Shin H, Lee M. , et al. Percutaneous autologous fat injection following 2-layer flap lower blepharoplasty for the correction of tear trough deformity. J Craniofac Surg 2018; 29 (05) 1241-1244
    CrossrefPubMedGoogle Scholar
  • 7 Skippen B, Bernardini FP, Fezza J, Hartstein ME. Autologous fat grafting for treating blepharoplasty-induced lower eyelid retraction. Plast Reconstr Surg Glob Open 2016; 4 (12) e1190
    CrossrefPubMedGoogle Scholar
  • 8 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 (05) 1515-1522
    CrossrefPubMedGoogle Scholar
  • 9 Meier JD, Glasgold RA, Glasgold MJ. 3D photography in the objective analysis of volume augmentation including fat augmentation and dermal fillers. Facial Plast Surg Clin North Am 2011; 19 (04) 725-735
    CrossrefPubMedGoogle Scholar
  • 10 World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310 (20) 2191-2194
    CrossrefPubMedGoogle Scholar
  • 11 United States Department of Health and Human Services Office for Civil Rights. Health Insurance Portability and Accountability Act Research. 2002 , revised 2017;45 CFR 164.501, 164.508, 164.512(i)
    PubMedGoogle Scholar
  • 12 Loeb R. Fat pad sliding and fat grafting for leveling lid depressions. Clin Plast Surg 1981; 8 (04) 757-776
    CrossrefPubMedGoogle Scholar
  • 13 Loeb R. Naso-jugal groove leveling with fat tissue. Clin Plast Surg 1993; 20 (02) 393-400 , discussion 401
    CrossrefPubMedGoogle Scholar