Percutaneous Aponeurotomy and Lipofilling in Complex Periorbital Scar Revision

Periorbital scars and deformities pose a significant challenge due to the region's delicate anatomy and esthetic importance. This case series explores the application of percutaneous aponeurotomy and lipofilling (PALF) in three patients with complex periorbital scarring resulting from surgical, traumatic, and pathological causes. The PALF technique involves subcision to release fibrotic tissue tethering scars, followed by injection of processed autologous fat to restore volume and improve contour. Patients demonstrated notable improvements in functional outcomes, such as eyelid mobility and prosthesis positioning, and esthetic results, including enhanced symmetry and scar improvement. No significant complications were observed. This study highlights PALF as a safe and effective treatment for restoring function and esthetics in the management of periorbital scars. Further research is warranted to validate its long-term efficacy and broader applicability.