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Supraperiosteal fat repositioning with midface lift in lower eyelid blepharoplasty: an 18-year experience

  • Oculoplastics and Orbit
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To assess the clinical outcomes of fat repositioning via supraperiosteal dissection with midface lift for correction of tear trough deformity in a large Asian patient population.

Methods

Retrospectively review 1152 Asian patients who underwent fat repositioning to the supraperiosteal plane with a midface lift between 2005 and 2022. Surgical technique, postoperative course, and complications were recorded. At the 6-month postoperative follow-up, the degree of patient satisfaction was assessed.

Results

A total of 2304 eyes from 1152 patients with an average follow-up of 10 months. These procedures were performed using a transforniceal approach in 185 patients (16%) or a transcutaneous skin excision approach in 967 patients (84%). Among the patients who underwent the transcutaneous technique, seven individuals (0.6%) experienced effective treatment of lower lid ectropion through lateral tarsal strip procedures. Nine patients (0.7%) required revision surgery to address the remaining lateral fat pad due to inadequate lateral orbital fat excision during the initial procedure. At the 6-month follow-up, most patients reported a high level of satisfaction, with 800 patients (78%) expressing extreme satisfaction and 196 patients (19.1%) reporting satisfaction with the improvement in their appearance. No one reported facial numbness, lower eyelid or cheek paralysis, newly developed diplopia or granuloma formation.

Conclusion

The procedure of fat repositioning involving supraperiosteal dissection and a midface lift, whether performed using a transforniceal approach or a transcutaneous skin excision approach, in lower eyelid blepharoplasty proves to be a secure and auspicious surgical technique for rectifying tear trough deformity and attaining a pleasing aesthetic outcome.

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Authors and Affiliations

  1. Department of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA

    Anny Mansim Cheng & Sirtaz Singh Sibia

  2. Specialty Retina Center, Coral Springs, FL, USA

    Anny Mansim Cheng & Sirtaz Singh Sibia

  3. Department of Ophthalmology, Florida Internation University, Herbert Wertheim College of Medicine, Miami, FL, USA

    Anny Mansim Cheng

  4. Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan

    Ann Yi-chiun Chuang

  5. Department of Ophthalmology, Mackay Children’s Hospital, Taipei, Taiwan

    Ann Yi-chiun Chuang

  6. Department of Ophthalmology, National Taiwan University Hospital, No.7, Chung-Shan South Rd, Taipei, Taiwan

    Yi-Hsuan Wei & Shu-Lang Liao

  7. National Taiwan University, School of Medicine, Taipei, Taiwan

    Yi-Hsuan Wei & Shu-Lang Liao

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  1. Anny Mansim Cheng
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  2. Ann Yi-chiun Chuang
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  3. Yi-Hsuan Wei
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  4. Sirtaz Singh Sibia
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  5. Shu-Lang Liao
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Contributions

Conceptualization: Anny M.S. Cheng, Shu-Lang Liao; Methodology: Anny M.S. Cheng, Ann Yi-chiun Chuang, Yi-Hsuan Wei, Sirtaz S. Sibia, Shu-Lang Liao; Formal analysis and investigation: Anny M.S. Cheng, Shu-Lang Liao; Writing—original draft preparation: Anny M.S. Cheng, Ann Yi-chiun Chuang, Yi-Hsuan Wei, Sirtaz S. Sibia; Writing—review and editing: Anny M.S. Cheng, Ann Yi-chiun Chuang, Shu-Lang Liao; Supervision: Shu-Lang Liao

Corresponding author

Correspondence to Shu-Lang Liao.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the [ethics committee of National Taiwan University Hospital (Taipei, Taiwan)] and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The ethics committee of National Taiwan University Hospital (Taipei, Taiwan) has approved the study with IRB# 202307162RIND.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Cheng, A.M., Chuang, A.Yc., Wei, YH. et al. Supraperiosteal fat repositioning with midface lift in lower eyelid blepharoplasty: an 18-year experience. Graefes Arch Clin Exp Ophthalmol (2024). https://doi.org/10.1007/s00417-024-06412-1

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  • DOI: https://doi.org/10.1007/s00417-024-06412-1

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