Lower blepharoplasty with transposition of fat pads and percutaneous fixation
Keywords:
lower and periorbital palpebral aging, lower blepharoplasty, subperiosteal transposition of lower palpebral fat pads.Abstract
Introduction: Protrusion of palpebral fat pads is a characteristic sign of facial aging. Currently, the tendency is to perform conservative blepharoplasty with more repositioning and less resection of pseudoherniated fat pads.
Objective: To describe the outcomes of blepharoplasty with subperiosteal transposition of the lower palpebral fat pads and percutaneous fixation.
Methods: A descriptive, prospective and longitudinal study was carried out in patients who attended the plastic surgery office of Hermanos Ameijeiras Clinical Surgical Hospital from April 2016 to December 2020 and met the inclusion criteria. The sample consisted of 31 patients who stayed until the end of the study.
Results: The mean age of the patients was 52.3 ± 4.7 years, with predominance of female sex (83.9 %) and patients with white skin color (61.3 %). The most frequent palpebral and periorbital signs of aging were protrusion of medial fat pads (100 %), marked nasojugal sulcus (100 %) and presence of blepharogenic pad (93.5 %). In the postoperative period (six months), total correction of the inferomedial palpebral bags, as well as disappearance of the nasojugal sulcus and blepharogenic pad, was observed, accounting for 45.2 % and 54.8 % of patients, respectively. Cases with good and satisfactory aesthetic outcomes predominated. Only five patients (16.1 %) presented complications, which were totally reversible.
Conclusions: Blepharoplasty with subperiosteal transposition of the palpebral fat pads and percutaneous fixation is a procedure with good aesthetic outcomes and a high percent rate of satisfaction.
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References
Mendelson B, Wong CH. Anatomía del envejecimiento facial. En: Neligan PC, Warren RJ. Cirugía Plástica. 3rd ed, Vol 2: Estética. Colombia: Ediciones Médicas AMOLCA. 2017. pp. 78-92.
Castañares S. Blepharoplasty for herniated intraorbital fat. Plast Reconstr Surg. 1951 [acceso: 12/07/2018];8:46. Disponible en: https://pubmed.ncbi.nlm.nih.gov/14864073/
Flowers RF. Tear trough implants for correction of tear trough deformity. Clin Plast Surg. 1993 [acceso: 18/01/2018];20:403-15. Disponible en: https://pubmed.ncbi.nlm.nih.gov/8485949/
Loeb R. Fat pad sliding and fat grafting for leveling lid depressions. Clin Plast Surg. 1981 [acceso: 22/03/2018];8:757-76. Disponible en: https://pubmed.ncbi.nlm.nih.gov/7338007/
Hamra ST. Arcus marginalis release and orbital fat preservation in midface rejuvenation. Plast Reconstr Surg. 1995 [acceso: 22/02/2018];96:354-62. Disponible en: https://pubmed.ncbi.nlm.nih.gov/7624408/
Hamra S. The role of the septal reset in creating a youthful eyelid-cheek complex in facial rejuvenation. Plast Reconstr Surg. 2004 [acceso: 28/04/2018];113:2124-41. Disponible en: https://pubmed.ncbi.nlm.nih.gov/15253208/
Goldberg RA. Transconjunctival orbital fat repositioning: transposition of orbital fat pedicles into a subperiosteal pocket. Plast Reconstr Surg. 2000 [acceso: 09/05/2019];105:743-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/10697189/
de la Plaza R, Arroyo JM. A new technique for the treatment of palpebral bags. Plast Reconstr Surg. 1988 [acceso: 10/05/2019];81:677-85. Disponible en:
https://pubmed.ncbi.nlm.nih.gov/3362986/
Guerrero R. La importancia de la posición del ojo en el rejuvenecimiento facial. En: Rejuvenecimiento facial. El concepto Ibero latinoamericano. Bogotá: FILACP Impresión Médica. 2013. pp. 203-19.
Rohrich RJ. The evolving role of blending of the lid-cheek junction in lower blepharoplasty. Plast Reconstr Surg. 2018 [acceso: 10/07/2019];142(2):377-82. Disponible en: https://journals.lww.com/plasreconsurg/Abstract/2018/08000/The_Evolving_Role_of_Blending_of_the_Lid_Cheek.17.aspx
Kossler AL. Current trends in upper and lower eyelid blepharoplasty among American Society of Ophthalmic Plastic and Reconstructive Surgery Members. Ophthalmic Plast Reconstr Surg. 2018 [acceso: 27/08/2020];34(1):37-42. Disponible en: https://www.ingentaconnect.com/content/wk/iop/2018/00000034/00000001/art00024
Duan R. Modified lower blepharoplasty with fat repositioning via transconjunctival approach to correct tear trough deformity. Aesth Plast Surg. 2019 [acceso: 09/03/2020];43(3):680-5. Disponible en:
https://link.springer.com/article/10.1007/s00266-019-01309-5
Malik A, Denisova K, Barmettler A. Contemporary Management of the periocular area. Curr Otorhinolaryngol Rep. 2021 [acceso: 10/01/2022];9:448-56. Disponible en: https://link.springer.com/article/10.1007/s40136-021-00367-1#citeas
Wilson SC. Lower eyelid blepharoplasty: does the literature support the longevity of this procedure? Aesth Surg J. 2018 [acceso: 27/07/2020];38(12):1289-97. Disponible en: https://academic.oup.com/asj/article/38/12/1289/5061882?login=false
Samimi DB, Massry GG. Transconjunctival lower blepharoplasty with and without fat repositioning. In: Murphy MR, Johnson CM, Massry GG, Fitzgerald R. Master Techniques in Facial Rejuvenation E-Book. Elsevier Health Sciences. 2018 [acceso: 27/07/2020]:131-41. Disponible en: https://www.sciencedirect.com/science/article/pii/B9780323358767000121
Ramesh S, Goldberg RA, Wulc AE, Brackup AB. Objective comparison of nasojugal fold depth and lower eyelid length after fat excision versus fat transpositional lower blepharoplasty. Aesth Surg J. 2019 [acceso: 18/07/2020];39(10):1048-54. Disponible en: https://academic.oup.com/asj/article/39/10/1048/5380407?login=false
Liying C, Xiaoming SY, Lingxiao Y, Lu C, Liucheng Z, Xiyuan M. Fan-shaped thin fat pedicles for tear trough correction through a layer-level fixation: A modified transconjunctival blepharoplasty. J Craniofac Surg. 2021 [acceso: 10/01/2022];32(6):2024-8. Disponible en: https://journals.lww.com/jcraniofacialsurgery/Abstract/2021/09000/Fan_Shaped_Thin_Fat_Pedicles_for_Tear_Trough.17.aspx
Garcia CP, Badin AZD. Treating tear trough deformity: transconjunctival blepharoplasty with fat pad repositioning and fixation in the intranasal mucosa. 18 Years’ Experience. Aesth Plast Surg. 2019 [acceso: 22/08/2021];43:695-701. Disponible en: https://link.springer.com/article/10.1007/s00266-019-01353-1#citeas
Cannon PS, Leather BB. Lower eyelid transconjunctival blepharoplasty with fat repositioning: outcomes and complications. Eur J Plast Surg. 2020 [acceso: 15/01/2021];43:719-26. Disponible en: https://link.springer.com/article/10.1007/s00238-020-01671-7
Su KH, Ri KB, Woong YS. Pedicled Fat transposition vs Free-fat grafting for lower blepharoplasty with volume preservation. Reply. JAMA Facial Plast Surg. 2019 [acceso: 18/07/2020];21(5):463-5. Disponible en: https://www.liebertpub.com/doi/abs/10.1001/jamafacial.2019.0480?journalCode=jamafacial
Akkaya S. Evaluation of surgical outcomes, patient satisfaction, and potential complications after blepharoplasty. Beyoglu Eye Journal. 2018 [acceso: 18/07/2020];3(2):91-5. Disponible en: https://www.researchgate.net/profile/Sezen-Akkaya/publication/325976909_Evaluation_of_Surgical_Outcomes_Patient_Satisfaction_and_Potential_Complications_after_Blepharoplasty/links/5cb848184585156cd7a00520/Evaluation-of-Surgical-Outcomes-Patient-Satisfaction-and-Potential-Complications-after-Blepharoplasty.pdf
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