The Contouring of ROOF in Upper Blepharoplasty

Abstract

In patients seeking upper eyelid blepharoplasty who also have ptosis of the eyebrows, the lateral brow fat pad can be contoured to help in highlighting the lateral aspect of the superior orbital rim. Excision of brow fat pad is an extremely valuable adjunct to blepharoplasty surgery in some patient with heaviness and bulkiness in the lateral upper orbital region. The brow fat pad lies directly posterior to the eyebrow skin and orbicularis oculus muscle and aids in smooth gliding of the eyebrow with animation. Retroorbicularis oculus fat (ROOF) is in reality an extension of the brow fat pad that lies along the superior orbital rim and directly deep to the orbicularis muscle. Through the incision of standard blepharoplasty, resection of retroorbicularis oculus fat and elevate the eyebrow would appear to be a useful adjunct in select patients.