Use of a novel orbicularis oculi muscle overlap method for correction of tear-trough deformity.

Abstract

Although the fat-pad-sliding method reported by Loeb and the "arcus marginalis release with preservation of orbital fat" method reported by Hamra are useful techniques for correcting tear trough deformity in the Asian population, including Japanese patients, occasional cases of tear-trough deformity have persisted even after surgery. To solve this problem, the authors developed a novel orbicularis oculi muscle overlap method, which has enabled them to obtain good results. The orbicularis oculi muscle overlap method was performed for 10 patients (9 women and 1 man) with prominent tear-trough deformity. The average of these patients was 52 years (range, 34-72 years). The origin of the orbicularis oculi muscle was elevated at its adherence to the maxillary bone, and the innermost portion of the origin of the orbicularis oculi muscle was excised by a width of 6 to 7 mm to reduce the muscle tension. This muscle flap was overlapped relative to the orbital fat, which was repositioned over the orbital rim and sutured in place. Tear-trough deformity improved in all cases, and the patients were highly satisfied with their flat lower eyelids. The orbicularis oculi muscle overlap method is effective for thin eyelids with prominent tear-trough deformity. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .