Abstract ID: 26-366
Combined Fat Transposition and Pearl Lower Blepharoplasty
Author: Dan Georgescu Base Hospital / Institution: Uptown Clinique
Presentation Type: ePoster Presentation
Purpose
Volume redistribution at the time of lower blepharoplasty can be achieved by fat transposition or fat excision with fat pearls. While fat transposition fills in primarily the cheek side of the tear trough, fat pearls tend to sit mostly above the tear trough (on the eyelid side), inadequately volumizing the cheek. We present here a hybrid approach of combined transposition and fat pearls for optimal lower eyelid volume redistribution.
Methods
Video presentation of surgical technique and retrospective chart review of the last 20 consecutive patients treated with combined fat transposition and pearls. A blind observer was asked to grade the improvement in lower eyelid – cheek transition in each operated eye using a scale from 0 to 5 where 0 was given for no improvement and 5 for fully effaced tear trough.
Surgical technique: A transconjunctival lower eyelid approach was used to create the pre-periosteal pocket and the medial and central fat was transposed and anchored with resorbable barbed sutures. The lateral fat pad was excised and trimmed into 3mm diameter pearls that were laid above the transposed fat on the eyelid side of the junction.
Results
All patients included in the study were very satisfied with the final cosmetic result. There were no major complications seen in either group. The improvement in lower eyelid – cheek junction was 4.83+/-0.1 in the study group and 4.52+/-0.07 in the control (transposition only) group (p<0.05).
Conclusion
Hybrid fat transposition and pearls lower blepharoplasty is a safe and effective procedure that allows for a smoother eyelid-cheek transition with better redistribution of fat above and below the tear trough. Although, in our patients, most fat pearls came from the lateral fat pocket, in certain cases, un-transposable medial or central fat was also used.
Although a larger, prospective study is certainly warranted, this small retrospective study supports the safety and efficacy of hybrid fat transposition and pearls for optimal volume redistribution at the time of lower blepharoplasty.