Orbital fat preservation in lower-lid blepharoplasty

In the last 4 years, there have been a few reports concerning unconventional management of the fat posterior to the orbital septum (intraorbital) as well as periorbital fat located superficial to the orbital septum in a plane both superficial and deep to the orbicularis oculi muscle. With reference to intraorbital fat, some reports suggest that this fat be preserved and mobilized to other areas to recontour the lower lid, while other authors suggest repositioning the fat within the bony orbit. To address these new concepts, a discussion of the theories behind these approaches is needed.