Periorbital Fat Grafting and its Effect on Upper Eyelid Height

Abstract

Introduction: Recently there has been an evolving paradigm shift toward the treatment of facial volume loss either alone or in conjunction with more traditional modalities. Although volume augmentation is commonly used in rejuvenation of the upper orbital sulcus and brow, the effect on the upper eyelid has not yet been documented. This article describes one clinician's experience (A.N.K.) with autologous fat grafting to the upper orbital sulcus and the effect on upper eyelid position. Materials and Methods: After a detailed clinical evaluation of the periorbital region including overall facial aging, brow position, and eyelid laxity, 7 patients underwent autologous fat transfer to the periorbital region. Comparison of photos taken before and after the procedure showed a clear increase in the upper eyelid height. Results: All 7 patients described in this study demonstrated objective increase in upper lid height after periorbital autologous fat transfer, ranging from 0.41 mm to 2.08 mm, with a mean of 1.00 mm. Discussion: Periocular volume augmentation and its effect on lower eyelid position have been described previously. An attempt to alter upper eyelid height with volume augmentation directly to the upper eyelid has also been described recently. However, to the authors' knowledge, this is the first report of volume augmentation to the periorbital region affecting upper eyelid position in this manner. The clinical application of this observational data is not yet clear. However, the potential exists for extension of this modality to upper eyelid malposition such as ptosis.