Correction of Mild-to-Moderate Sunken Upper Eyelids of Asians with Stromal Vascular Fraction Gel

INTRODUCTION: Fat grafting is an efficient and safe procedure for the correction of upper eyelid sulcus deepening. Stromal vascular fraction (SVF) gel has been proven to be an ideal fat derivative and can be widely used for facial augmentation. We aimed to determine the efficacy of SVF gel for the correction of a mild-to-moderate sunken superior sulcus among Asian patients. METHODS: Patients with a mild-to-moderate sunken superior sulcus underwent SVF gel grafting of the sunken upper periorbital area. The primary result was the quantitative volume difference in the superior sulcus region before and after grafting. This was evaluated through three-dimensional VECTRA(®) imaging. The secondary results included the aesthetic quantitative evaluation results (upper lid area and pretarsal space ratio), global aesthetic improvement scale (GAIS) score, and complications. RESULTS: Thirty-one patients with mild-to-moderate sunken upper eyelids were included in this study. The average unilateral injected amount was 1.235 mL (± 0.171 mL). The 1-year delta volume was 0.801 ± 0.086 mL, and the effective survival volume was 65.3% (± 6.1%). The median preoperative pretarsal space and upper lid area ratio was 1.010 (± 0.150). The median postoperative pretarsal space and upper lid area ratio at 1 year was 0.159 (± 0.031) (n = 62; P < 0.0001), indicating a significantly reduced sunken appearance. The average GAIS score was 2.174 (± 0.391). All patients were satisfied with their surgical outcomes. The reoperation rate was 12.9%. CONCLUSIONS: SVF gel is safe and effective for the treatment of a mild-to-moderate sunken superior sulcus and is associated with satisfactory clinical outcomes and short recovery times. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40123-022-00615-7.