Pretarsal Augmentation of the Lower Eyelids Using Fat Grafts in Asian Patients.

Abstract

Surgical procedures are required to achieve long-term pretarsal roll fullness of the lower eyelids with a satisfactory appearance. To assess the efficacy of a surgical method using fat grafts for pretarsal augmentation of the lower eyelids. We conducted a retrospective clinical study that included 12 Japanese patients (24 lower eyelids) who underwent pretarsal augmentation of the lower eyelids using fat grafts and were followed up for more than 6 months. Morphometric measurements of the projection, width, and area of the pretarsal roll fullness of the lower eyelids were performed. Additionally, surgical outcomes and complications were assessed. Pretarsal roll fullness of the lower eyelids was achieved for more than 6 months postoperatively. The surgery resulted in enlarged eyes with sufficient pretarsal roll fullness, and all patients were satisfied with the aesthetic outcomes. The mean projection (1.6 ± 1.0 vs 0.5 ± 0.6 mm), width (7.4 ± 1.5 vs 4.4 ± 3.6 mm), and area (143.5 ± 42.2 vs 32.8 ± 39.6 mm2) of the pretarsal roll fullness of the lower eyelids were significantly greater postoperatively than preoperatively (P < .05). No early postoperative complications were observed during the 6- to 12-month follow-up period. However, overcorrections were observed in 2 cases (16.7%) due to late-onset fat overgrowth, which was corrected by revision surgery. Fat grafting can help achieve sufficient pretarsal roll fullness of the lower eyelids. The technique presented herein is a simple and reliable alternative surgical procedure for creating pretarsal roll fullness of the lower eyelids.