CORRECTION OF SUNKEN AND/OR MULTIPLE FOLDED UPPER EYELID BY FASCIA-FAT GRAFT

초록

Sunken and/or multiple folded upper eyelid is one of the common troublesome complication after oriental blepharoplasty. In addition to orbital depletion, the traumatic surgical procedure of excessive fat removal might result a varying degree of adhesion and injury to the orbital septum. Adhesiotomy followed by a restoration of volume is generally believed to be the logical way to correct such deformity. To restore the volume and prevent re-adhesion, local tissues of the upper eyelid, free fat graft and dermis-fat graft have been used. However, local tissues are usually insufficient due to previous surgery and the survival rate of grafted fat is often unpredictable, moreover, the heaviness of the dermis-fat composite make it a less than satisfactory choice. We value the use of free fascia-fat composite grafts for the treatment of such disfigurements. The fascia-fat composite is expected to have better survival than free fat alone and also to be lighter than a dermis-fat composite, moreover, it is abundant throughout the body and provides closer anatomical structure to the repair site namely, the damaged orbital septum and fat. We prefer mons pubis, preauricular and temporal area for the donor site according to the status of damage. We treated 13 patients with sunken and/or multiple folded upper eyelids by fascia-fat composite grafts obtained satisfactory results.