The mysterious second temporal fat pad

Temporal eyelid fullness due to residual herniation of orbital fat is a complication of cosmetic oculoplastic surgery. It frequently occurs despite the surgeon's excision of temporal herniated orbital fat and requires a second surgical procedure to remove. Anatomists have demonstrated three lower eyelid fat pads, temporally, centrally, and nasally. I have found a second temporal fat pad that was not evident until the first had been removed. Searching for and excising the second temporal fat pad have eliminated the complication of residual temporal lower, eyelid fat herniation following cosmetic eyelid surgery.