摘要

Objectives: Sunken eyelids represent a difficult aesthetic condition to correct, and this lecture will present multiple surgical approaches for their correction during double eyelid procedures. Introduction: Sunken eyelids generally create an aged, tired, and skeletonized facial appearance. However, sunken eyelids are difficult to correct with a single universal method. Because the underlying causes vary, treatment should be tailored accordingly. Depending on the patient’s condition, various approaches may be used, ranging from simple hyaluronic acid filler injection to fat grafting, fat transposition, and other surgical techniques. Selecting the most appropriate method for each patient is essential to achieving favorable outcomes. Materials / method: In this study, we introduce two surgical approaches: orbital fat transposition performed simultaneously with a subbrow lift, and orbital fat transposition performed simultaneously with upper blepharoplasty. Results: A subbrow lift is particularly useful for correcting lateral hooding, and transposition of the medial orbital fat toward the central orbital fat compartment is effective for improving sunken eyelids. During upper blepharoplasty, the redundant lateral portion of the central orbital fat can be rotated and connected to the medial fat pad to restore upper eyelid volume. Conclusion: Depending on the cause of sunken eyelids, improvement may be achieved with correction of blepharoptosis alone. In cases of orbital fat depletion, sunken eyelids can be improved with hyaluronic acid filler injection or, during surgery, with orbital fat transposition.