Chemical Lipolysis of the Infraorbital Fat Pads

Abstract

Baggy, puffy eyelids are viewed by most people as a sign of exhaustion and aging. Many individuals will go to great lengths to improve the appearance of their periorbital skin using cosmetics, fillers, botulinum toxin, chemical peels, dermabrasion, lasers, and surgical procedures.

The fourth most popular surgical cosmetic procedure is blepharoplasty, a method to attain a more desirable appearance. However, patients desire similarly effective yet less invasive solutions with faster recovery times.

Baggy eyelids result from periorbital fat herniation, excessive eyelid skin (blepharochalasis), and/or hypertrophied orbicularis muscle. Baggy infraorbital folds caused by herniation of infraorbital fat pads are anatomically defined as true herniation of one or more of the tree lower lid fat pads between the capsulo-palpebral ligament superiorly and the orbital septum inferiorly. These must be clinically differentiated from other causes of periorbital edema, including eczema, conjunctivitis, urticaria, angioedema, arthropod bites, trauma, sinusitis and, uncommonly, rosacea, dermatomyositis, thyroid disease, amyloidosis, hypoproteinemia, hypervolemia, and lymphoma, among others.

This technique provides a nonsurgical alternative for our patients.