Blepharoplasty Of Orbital Fat Release And Preservation Through Transconjunctival Route

Background:Lower eyelid occur in young patients for many reasons, mostly due to genetic factors, orbital fat hypertrophy, hyperplasia. As patients age, the elasticity of the lower eyelid is reduced, regression of the orbicularis oculi muscle causes the tension of the orbital membrane to weaken, leading to the formation of dermatochalasis of orbital fat moving forward to the thinner area of the orbital septum. Further, gravity affect the infraorbital superficial soft tissues to prolapse towards the cheek, causing a thinning of the soft tissue and forming the infraorbital depression groove. Conventional surgery for dermatochalasis usually uses either transconjunctival or skin incision, to improve the protrusion by removing orbital fat. Most young patients have fat protrusion of the lower eyelids, good skin elasticity, and shallow and narrow orbitopalpebral sulcus; the transconjunctival route is taken to remove the herniated fat. Other than a prominent depression, older patients present loose skin, with deep and broad orbitopalpebral sulcus; the deformity appeares to have a double convex from the side. Removal of orbital fat may cause an unevenness of the lower eyelids with more prominent partial depression and orbitopalpebral sulcus. Therefore, the skin incision route designed by Hamra was generally used to preserve and release orbital fat, lift the orbicularis oculi muscle, and remove loosened skin.Purpose:Using the appropriate surgical method to augment cosmetic defects focused on the orbitopalpebral sulcus, for patients without significant loosening of the skin and non-apparent wrinkles in the lower eyelids. Method:Before operation, we should assess the patient's condition, understand what they expect the results of operation, and then select the appropriate surgical method: blepharoplasty of orbital fat release and preservation through transconjunctival route.Result:12 subjects received treatment using the blepharoplasty of orbital fat release and preservation through transconjunctival route; both the surgery and recovery process went smooth. The depression of the orbitopalpebral sulcus was corrected or greatly improved during the 3-6 months follow-up; dermatochalasis was improved.Conclusion:This approach should be used for patients with cosmetic defect focused on the orbitopalpebral sulcus with non-significant loosening and wrinkling of the skin in the lower eyelid for reconstruction.