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Journal of the Korean Society for Aesthetic Plastic Surgery 2008;14(2):139-144.
Published online September 1, 2008.
Correction of Sunken Upper Eyelids Using Incisional Double Eyelidplasty and Autologous Microfat Grafting into Orbital Septum.
Dong Ju Yoon, Cheol Uk Kang, Yong Chan Bae
Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University, Busan, Korea. kcu36.5@daum.net
Abstract
Sunken upper eyelids are one of the common and complicated problems that occur with an aging process or after double eyelidplasty. Autologous microfat grafting is a technique that has frequently been used for sunken eyelids. The traditional blind method of microfat grafting has a some complications. Therefore, we performed the open method with incisional double eyelidplasty. Between June, 2005 and February, 2008, we performed incisional double eyelidplasty and autologous microfat grafting into orbital septum in 63 patients(124 cases) with sunken upper eyelids. The fat was harvested from periumbilical regionand centrifuged at 3000 rpm for 3 minutes. After the middle fat layer was obtained by 1cc syringe, we made skin incision and separated orbital septum(inner layer) and levator aponeurosis. And then, we injected the microfat into orbital septum with 0.9 mm blunt cannula. At this time, one of the important things was to make the patient gaze upward during the fat injection. All the patients were satisfied, except 5 cases which were 3 cases of undercorrection and 2 cases of asymmetry. Surgical revision was required for only the above 5 cases(4%). Patients with some transient complications of ptosis (13 cases), overcorrection(4 cases) and nodular appearance(2 cases) were self-improved. We found that the method using incisional double eyelidplasty and autologous microfat grafting into orbital septum has many advantages which include less traumatic, less complication rate, less absorption rate of fat. and less burden of patients.
Key Words: Eyelids, Graft, Subcutaneous fat / Sunken eyelid, Micro fat graft


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