Objectives: Lipofilling of the lower eyelid region: looking for three "ideal" surgical planes
Introduction: The tear trough is the groove at the junction between lower eyelid and cheek. Due to aging, atrophy of the adjacent tissues and thinning of the skin occurs, leading to increased visibility of this deep attachment between the skin and orbital rim. Quite often, the fat around the eyes depletes and shifts creating a sunken eye look with a poor skin quality. It is one of the most difficult depressions to correct surgically.
Materials / method: During the last 10 years the Author has used microlipofilling in the lower periorbital area. After harvesting the adipose tissue and decantation, lipofilling was performed in different surgical planes with cannulas of various diameters, starting from the deep subperiosteal plane to the subdermal one, to ensure a better take of the implanted fat. The amount of fat injected ranged from 0.5 to 3 cc each side for the simple correction of tear trough, or more, when the treatment of the zygomatic region is also associated.
Results: The results were satisfactory and were improving as the fat injection method was perfected. Unlike other regions of the body, in the periorbital zone we never perform overcorrection and this may explain why in some cases the correction was not adequate. In some patients a second procedure was performed.
Conclusion: Microlipofilling is a good surgical option to correct tear trough and to increase volume and projection to flat cheeks as well. Adding to that, ADSC (Adipose-Derived Stem Cells) present in the fat, have a positive effects on skin quality, improving skin texture and color. Important qualities, such as repair and regenerate tissues, are commonly seen in our clinical application of lipofilling, so that it can be indicated not only for his “filling” effects or volumetric enhancements, but also for the added value of regeneratives properties.
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