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Fat Injection as a Valuable Tool for Lower Eyelid Retraction Management: A Retrospective, Observational, Single Blind and Case—Control Study

  • Original Article
  • Oculoplastic
  • Published:
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Abstract

Background

The aim of this study was to evaluate the use of autologous fat graft injection to correct lower eyelid position

Methods

A retrospective, observational, single blind, case—control study was carried out on 94 patients, presenting with lower eyelid retraction in 159 eyes. In the sub-population with monolateral eyelid retraction, the not affected site has been considered as a control and compared with the outcomes recorded after treatment of the contralateral side

Follow-up at 12 months was performed with a subjective assessment carried out by a questionnaire administered to patients while objective result assessment was performed 12 months after surgery by two independent blind examiners.

Results

The eyelid upward reposition has improved one year after fat grafting in both bilateral (1,52 mm) and unilateral (1,7 mm) population: the latter allowed to statistically validate (P<0.05) the result with respect to the not affected site.

Conclusions

This is the first paper that highlights the outcomes of sole fat injection in the treatment of lower eyelid retraction: blind objective evaluation of surgical outcomes along with a patient assessment of both functional and aesthetic improvement one year after surgery confirm its efficacy and reliability along with the first case/control outcome evaluation of the technique carried on in the sub-population of 29 patients affected by unilateral lower eyelid retraction that validate the average improvement of the retracted eyelid one year after fat grafting as statistically significant. Nevertheless, longer follow-up periods and a larger sample size are needed to thoroughly confirm surgical outcomes and statistical results.

Level of evidence 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.

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Acknowledgments

The authors would like to thank Giulia Tanteri MD, an independent medical writer, who provided English-language editing and journal styling prior to submission

Funding

Not applicable

Author information

Authors and Affiliations

  1. Rome, Italy

    Michele Pascali & Gloria Marchese

  2. Rigeneralab Centre for Regenerative Medicine, Corso Unione Sovietica 159/a, 10134, Turin, Italy

    Alberto Diaspro

  3. Plastic Surgery Academy, Via Novara 53, 00198, Rome, Italy

    Michele Pascali

Authors
  1. Michele Pascali
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  2. Gloria Marchese
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  3. Alberto Diaspro
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Correspondence to Alberto Diaspro.

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Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 The video presents Patient 2 before, and her outcome one year after fat grafting of retracted lower eyelid. Animated figures describe the mechanism of lower eyelid retraction and the effect of fat grafting, along with a surgical video of the injection technique, with technical description.

266_2022_3114_MOESM2_ESM.pdf

Supplementary file2 Lower eyelid retraction in the study population n=159: preoperative image (T0) compared with one-year postoperative image (T1). Wilcoxon test of Paired t test data.

266_2022_3114_MOESM3_ESM.pdf

Supplementary file3 Lower eyelid retraction in the monolateral eyelid retraction group n=29: preoperative image (T0) compared with one-year postoperative image (T1). Wilcoxon test of Paired t test data.

266_2022_3114_MOESM4_ESM.pdf

Supplementary file4 Statistical evaluation of Lower eyelid retraction treatment outcomes in the monolateral eyelid retraction group n=29: preoperative image (T0) with one-year postoperative image (T1). The statistical significance threshold was set at p<0.05. Wilcoxon test of Paired t test data 2.

266_2022_3114_MOESM5_ESM.pdf

Supplementary file5 Case—control evaluation made in the monolateral eyelid retraction group n=29, comparing the one-year outcome of the treated side (case) with the healthy eyelid (control). The statistical significance threshold set at p<0.05. Wilcoxon test of Paired t test data

266_2022_3114_MOESM6_ESM.pdf

Supplementary file6 Statistical evaluation made in the study population (n=94), comparing the one-year outcome with the preoperative image. The statistical significance threshold set at p<0.05.

266_2022_3114_MOESM7_ESM.pdf

Supplementary file7 Case—control evaluation made in the monolateral eyelid retraction group (n=29), comparing the one-year outcome of the treated side (case) with the healthy eyelid (control). The statistical significance threshold set at p<0.05.

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Pascali, M., Marchese, G. & Diaspro, A. Fat Injection as a Valuable Tool for Lower Eyelid Retraction Management: A Retrospective, Observational, Single Blind and Case—Control Study. Aesth Plast Surg 47, 235–244 (2023). https://doi.org/10.1007/s00266-022-03114-z

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