Skip to main content

Advertisement

SpringerLink
Log in

Correction of Upper-Eyelid Depression Through Retro-Orbicularis Oculi Fat (ROOF) Augmentation Using Periumbilical Adipose Graft

  • Original Article
  • Oculoplastic
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Objective

The authors sought to determine the efficacy of periumbilical fat block grafting to the orbital retro-orbicularis oculi fat (ROOF) layer to correct sunken-upper eyelids in Asians.

Methods

All patients complained about upper-eyelid hollowness and a variety of deformities. Invasive double-eyelid procedures were performed, and periumbilical fat blocks were grafted for these patients. The core procedure of this approach was to make a separation between the orbicularis oculi muscle and septum to expose the retro-orbicularis oculi fat (ROOF) and fixate the fat grafts to the desired region of ROOF.

Results

From February 2018 to October 2019, the novel technique was performed on 38 Chinese patients (76 eyes) in our department. After follow-up of 6–15 months, 35 patients (92%) showed satisfactory aesthetic results with approximately 20–40% fat absorption rate. No cases required a second procedure. Periumbilical scars remained hidden within the umbilicus area.

Conclusions

Periumbilical fat grafting in the ROOF of the sunken upper eyelid can both fill the depression and help correct over-wide double eyelid.

EBM Level IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig.1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Park S, Kim B (2011) Correction of superior sulcus deformity with orbital fat anatomic repositioning and fat graft applied to retro-orbicularis oculi fat for Asian eyelids. Aesthetic Plast Surg 35:162–170

    Article  Google Scholar 

  2. Oh SR, Chokthaweesak W, Annunziata CC, Priel A, Korn BS, Kikkawa DO (2011) Analysis of eyelid fat pad changes with aging. Ophthal Plast Reconstr Surg 27:348–351

    Article  Google Scholar 

  3. Coleman S, Saboeiro A, Sengelmann R (2009) A comparison of lipoatrophy and aging: volume deficits in the face. Aesthetic Plast Surg 33:14–21

    Article  CAS  Google Scholar 

  4. Collar RM, Boahene KD (2013) Adjunctive fat grafting to the upper lid and brow. Clin Plast Surg 40:191–199

    Article  Google Scholar 

  5. Coleman SR (1995) Long-term survival of fat transplants: controlled demonstrations. Aesthetic Plast Surg 19(5):421–425

    Article  CAS  Google Scholar 

  6. Massry G, Azizzadeh B (2013) Periorbital fat grafting. Facial Plast Surg 29(1):46–57

    Article  CAS  Google Scholar 

  7. Cuzalina A, Guerrero AV (2018) Complications in fat grafting. Atlas Oral Maxillofac Surg Clin North Am 26(1):77–80

    Article  Google Scholar 

  8. Sozer SO, Agullo FJ, Palladino H et al (2010) Pedicle fat flap to increase lateral fullness in upper blepharoplasty. Aesthet Surg J 30:161–165

    Article  Google Scholar 

  9. Yoon DY, Kang CU, Bae YC (2008) Correction of sunken upper eyelids using incisional double eyelid plasty and autologous microfat grafting into orbital septum. J Korean Soc Aesth Plast Surg 14:139–144

    Google Scholar 

  10. Hwang SH, Hwang K, Jin S, Kim DJ (2007) Location and nature of retro-orbicularis oculus fat and suborbicularis oculi fat. J Craniofac Surg 18:387–390

    Article  Google Scholar 

  11. Wang X, Wang H (2020) Anatomical studyand clinical observation of retro-orbicularis oculi fat (ROOF). Aesth Plast Surg 44:89–92

    Article  Google Scholar 

  12. Fagrell D, Enestrom S, Berggren A, Kniola B (1996) Fat cylinder transplantation: an experimental comparative study of three different kinds of fat transplants. Plast Reconstr Surg 98:90–96 discussion 7–8

    Article  CAS  Google Scholar 

  13. Eto H, Suga H, Matsumoto D et al (2009) Characterization of structure and cellular components of aspirated and excised adipose tissue. Plast Reconstr Surg 124:1087–1097

    Article  CAS  Google Scholar 

  14. Fulton JE, Parastouk N (2001) Fat grafting. Dermatol Clin 19(523–530):ix

    Google Scholar 

  15. Egido JA, Arroyo R, Marcos A (1993) Middle cerebral artery embolism and unilateral visual loss after autologous fat injection into the glabellar area. Stroke 24:615

    Article  CAS  Google Scholar 

  16. Yoon SS, Chang DI, Chung KC (2003) Acute fatal stroke immediately following autologous fat injection into the face. Neurology 61:1151

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Plastic and Aesthetic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China

    Xing Zhou

  2. Department of Plastic Surgery, Tongji Hospital, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 40074, Hubei, China

    Ning Zeng & Haiping Wang

Authors
  1. Xing Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ning Zeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haiping Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Haiping Wang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

For this type of study, informed consent is not required, but patients provided informed consent before the operation.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhou, X., Zeng, N. & Wang, H. Correction of Upper-Eyelid Depression Through Retro-Orbicularis Oculi Fat (ROOF) Augmentation Using Periumbilical Adipose Graft. Aesth Plast Surg 44, 2131–2136 (2020). https://doi.org/10.1007/s00266-020-01828-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-020-01828-6

Keywords

Search

Navigation