Infraorbital groove correction by microfat injection after lower blepharoplasty

Blepharoplasty alone cannot completely correct deep infraorbital grooves because of its limited ability to improve anatomical volume loss. As the concept of resolving periorbital fat atrophy to improve the infraorbital groove was introduced, several methods to properly fill the groove have been attempted. The purpose of this study was to present a new technique, involving the use of autologous fat from periorbital compartments, for infraorbital groove correction after lower blepharoplasty.

Fifty patients (mean age, 55.9 years; range, 41-75 years) underwent transcutaneous lower blepharoplasty between December 2016 and August 2018. Infraorbital septal fat was harvested during the operation; after lower blepharoplasty, transcutaneous microfat was injected into the infraorbital groove.

One month after the procedure, 46 patients were satisfied or very satisfied with the results. One patient complained of an unsolved prominent infraorbital groove; additional microfat graft harvesting was performed from the abdomen after 6 months. Two patients complained of remnant septal bulging; additional transconjunctival fat was removed after 6 months. Five patients developed mild ectropion and recovered without any additional treatments. None of the patients developed infection, hematoma, lid retraction or any other complications.

Microfat injection after lower blepharoplasty has become popular. The method described in this study has certain advantages: the amount of correction is accurate, there is no donor-site morbidity and both subcutaneous and submuscular layers can be corrected simultaneously.