Application of Orbital Septum Fat Flap Stuffing to Correct Inferior Orbital Sulcus Deformities

The inferior orbitopalpebral sulcus deformity is challenging during lower eyelid blepharoplasty. Plastic surgeons are currently addressing each case individually, depending on the patient’s unique circumstances. Nevertheless, patients with large orbital grooves often complain that the inferior orbitopalpebral sulcus is not sufficiently improved. Altogether, 189 patients underwent transcutaneous blepharoplasty. According to their local anatomy, 98 underwent transcutaneous blepharoplasty surgery only, 59 had it combined with arcus marginalis release, and 32 had it combined with orbital septum fat flap stuffing. For the latter 32 patients, the orbital fat was trimmed and flipped to roll over the edge 10 mm from the infraorbital rim to form a base to repair the tear trough deformity and palpebromalar groove. Excessive dermatochalasis was removed, excrescent bulging fat was released, and the sulcus deformity was flattened using the orbital fat flap. The cosmetic results were satisfactory. Releasing the orbital septal fat helped restructure the deformity. The lower eyelid bags and lower orbital sulcus deformities were well corrected, allowing recovery with a convex-type facial contour. Using an orbital fat flap to treat a tear trough deformity and palpebromalar groove is effective and safe. Careful performances by surgeons can avoid serious complications. This operation satisfies both patients and surgeons.