Directional laminar resection of retro-orbicularis oculus fat: a method for upper eyelid heaviness correction

Abstract

Objective To apply an operative method of directional laminar resection of retro-orbicularis oculus fat(ROOF) for correction of upper eyelid heaviness. Methods From June 2017 to May 2018, 87 cases with preoperative diagnosis of puffy eyes were operated on the technique. In order to guide the resection of ROOF and orbital septum fat(OF), the upper eyelid was marked by three areas before the operation: lateral superior orbital region, orbital blepharoculi, and inferior orbital blepharoculi.Blepharoplasty was performed by septoaponeurosis junctional thickening technique. The epicanthoplasty was completed by inverted L-type technique. Drainage skin plate was placed in the incision and postoperative compression bandage was applied. Results Two patients developed postoperative hematoma in the right eye. The incisions healed well after debridement. Two cases of which developed superior sulcus in the left eye was improved after one months. The patients was followed 6 months to 12 months after surgery. All the patients were satisfied with the effect. Conclusions The technique was effective in reducing the heaviness of upper eyelid. In the operation, anatomical positioning of ROOF resection, complete retention of orbital septum and the release and anchorage of OF were the key steps to prevent complications. Key words: Puffy eyes; Retro-orbicularis oculus fat; Blepharoplasty