Lower Blepharoplasty Three-Dimensional Volume Assessment after Fat Pad Transposition and Concomitant Fat Grafting

Lower blepharoplasty is a commonly performed procedure to improve the aesthetic of the lower eyelid and upper midface. Combined fat pad transposition and fat grafting has not been previously studied using three-dimensional (3D) analysis. The aim of the study is to demonstrate the benefits of fat pad transposition with concomitant autologous fat grafting in lower blepharoplasty and to determine quantitative volumetric effects on the tear trough and lower periorbital region using Vectra^XT 3D imaging and analysis. A retrospective review was performed to identify patients undergoing primary lower blepharoplasty with combined fat pad transposition and fat grafting. The study time period was from September 2017 to March 2019 with a mean 6.5-month postoperative follow-up. This study was performed in a private practice institution (Kovac Cosmetic Center, Oakbrook Terrace, IL). Nine subjects were enrolled in the study with four males and five females. All subjects underwent lower blepharoplasty with combined fat pad transposition and fat grafting without any additional procedures. Preoperative and postoperative photographs were taken with the Vectra^XT 3D camera system and software. 3D photographs were then compared to assess the volume changes in the periorbital region. The volume in the lower periorbital region was assessed using 3D analysis. All subjects were found to have an increase in volume in the periorbital region. There was a mean volume gain of 2.84 mL on the right and 2.87 mL on the left. There was no statistical difference among volume gains between sides (p = 0.95). Combined fat pad transposition and autologous fat grafting is an effective procedure for improving the tear trough deformity and periorbital area. The use of 3D volume assessment is able to accurately measure and quantify the volume changes of the postoperative results.