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Objective:To investigate the method and effect of anatomic reduction of orbital septum fat in blepharoplasty to correct the first and second degree of upper eyelid depression.Methods:From January 2019 to January 2021, the data of patients with first and second degree upper eyelid depression admitted to Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. Orbital septum was fully exposed and cut in blepharoplasty, the orbital fat of upper eyelid central group and the medial group were dissected and seperated to form the fat flap pedicled on the medial side. The fat flap was rotated 180° to the medial side and fixed with the orbital fat of the medial group to correct the upper eyelid depression. Complications such as infection, hematoma, fat liquefaction, nodules and orthers were observed after surgery. Questionnaire was used to investigate the satisfaction of patients, with 1-4 points indicating dissatisfaction, general satisfaction, satisfaction and very satisfaction, respectively.Results:A total of 62 patients were included, all patients were female, aged 18-44 years, wit mean 27 years. All patients were bilateral upper eyelid depression. After 6 months of follow-up, the curvature of the double eyelid line was smooth, the width and narrowness of double eyelid were natural, and the upper eyelid depression was significantly improved. Satisfaction survey showed that 60 cases were very satisfied and 2 cases were satisfied. Wound infection was occurred in 1 case, and was cured after dressing change. Scar hyperplasia was observed in 2 cases, which was obviously alleviated after external treatment with anti-scar hyperplasia drugs. No fat liquefaction, nodule and other complications occured.Conclusions:For the first and second degree of upper eyelid depression, it can be corrected by anatomic reduction of orbital septal fat in blepharoplasty. The operation is simple, with fewer complication and high satisfaction.
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Objective:To explore the clinical effect of SVF-gel transplantation combined with double eyelid operation for upper eyelid depression.Methods:From January 2018 to October 2019, the Cosmetic Surgery Department of Henan Plastic Surgery Hospital treated 58 famale patients with sunken single eyelid and double eyelid, they aged 24-53, and the average age was (35±7) years old. A total of 58 patients with sunken upper eyelid were divided into two groups: SVF-gel group (study group) and traditional autologous fat (Coleman fat) group (control group), 29 cases in each group. Before the operation, patients in the study group were injected with SVF-gel, while those in the control group were injected with Coleman fat. After filling the fat, the traditional double eyelid line was designed in both groups.Results:Three months after operation, the patients in the study group and the patients in the control group had same survival rate of fat filling: the satisfactory rate of fat filling and the effect of double eyelid were 93.10% and 89.66% in the study group, respectively, while 82.76% and 82.76% in the control group.In the control group, there were 4, 1 and 3 cases of gross appearance, tubercle and unevenness respectively, while in the study group, there were no postoperative complications.Conclusions:SVF-gel is superior to traditional structural fat in the double eyelid surgery of upper eyelid sunken type. The patients are satisfied with the surgery and the clinical effect is good.
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Objective@#To summarize the clinical effects of meticulous fat transplantation with fat grafts in the treatment of sunken upper eyelid.@*Methods@#From September 2016 to January 2019, 58 patients with sunken upper eyelid were treated in the 940th Hospital of the Joint Logistic Support Force of PLA. There were 2 males and 56 females, aged from 20 to 63 years. Among them, 14 cases were congenital, 30 cases were senile, 8 cases were postoperative, and 6 cases were traumatic. The prepared autologous granule fat was extracted with a 1 ml syringe, which matched with a 1.0 mm diameter needle. The 1 ml syringe was packed into the card slot of a fat graft booster, and the needle was inserted into the orbital fat zone of a depressed upper eyelid to homogenously inject the granule fat. For patients with iatrogenic and traumatic upper eyelid depression, the adhesion was released by small needle knife before injection. For those with aging skin, subcutaneous injection of nano-fat was applied.@*Results@#The amount of granule fat transplantation was 0.5 ml to 3.6 ml, with an average of 1.5 ml. The amount of nano-fat injection was 0.5 ml to 1.0 ml, with an average of 0.7 ml. All patients were followed up for 1 month to 2 years. Except 2 patients with severe traumatic upper eyelid depression, the other patients were satisfied with their full and natural upper eyelids after treatments.@*Conclusions@#When the upper eyelid depression was treated with granule fat transplantation by the booster, the small needle knife peeling technique and nano fat transplantation can be combined to correct different types of congenital, aging and surgical derived sunken upper eyelid and traumatic sunken upper eyelid from mild to severe cases. At the same time, the skin of the upper eyelid can be rejuvenated as well.
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Objective To explore the method and effect of orbital lateral fat replacement combined with orbicularis oculi muscle flap for correction of severe upper eyelid depression with multiple eyelid.Methods From January 2014 to January 2017,26 patients with severe upper eyelid sag with multiple eyelid were treated in Department of Plastic Surgery,Huai'an Second People's Hospital,including 18 cases of multiple physiological sag eyelid,improper operation on the formation of 8 cases of multiple eyelid eyelid sag.All the patients adopt outside orbital fat reset with the orbicularis muscle flap folded for the treatment.Results The follow-up time was 6 months to 1 year,with an average of 8.5 months.23 patients with upper eyelid sag with multiple eyelid were rectified,3 cases of upper eyelid depression associated with multiple eyelid depression alleviated,multiple eyelid disappeared,including 5 cases of preoperative patients with mild ptosis,and symptoms improved after surgery.Conclusions The orbital lateral fat replacement combined with orbicularis oculi muscle flap folding is a safe and effective treatment for upper eyelid depression with multiple eyelid.