Overview
Conventional lower blepharoplasty removes fat from under the eye, which can leave an "operated" appearance. This paper describes preserving that fat and moving it over the complete inferior orbital rim. The author uses it in eyelid surgery alone and with composite rhytidectomy. The abstract reports no patient numbers or measured results.
Findings
- Lower orbital fat is preserved rather than removed.
- The fat is advanced over the complete inferior orbital rim to hide the bony framework that becomes visible with normal aging.
- The goal is a narrower, more shallow orbit and a youthful eyelid-cheek complex.
- The technique is used routinely in isolated blepharoplasty and with composite rhytidectomy.
- It accompanies repositioning of the orbicularis oculi muscle, cheek fat and facial platysma muscle.
- It can correct problems after surgery caused by excess orbital fat removal, lower eyelid retraction, and contour problems from malar augmentation.
What it means for a patient
- Removing under-eye fat can leave a hollow, "operated" look. Moving the fat over the bony rim instead aims to keep a smooth lid-cheek transition.
- The method is also offered to repair earlier surgery: too much fat removed, a lower lid pulled down, or contour problems after cheek implants.
- It is often done as part of a larger face lift that lifts the cheek and the muscle around the eye.
- Limits: one surgeon's concept and technique. The abstract gives no numbers on results or complications.
Why this paper matters
It presents orbital fat as one of the deep parts of the face that must be preserved and repositioned rather than removed. It offers preservation as an alternative to the fat removal of conventional blepharoplasty. Cited 126 times (NIH iCite, 2026-09-25).
Terms
- Orbital fat: the fat that cushions the eye inside the eye socket; it bulges forward as "bags" with age.
- Inferior orbital rim: the bony edge of the eye socket below the eye.
- Blepharoplasty: eyelid surgery that removes or repositions skin, muscle or fat.
- Eyelid-cheek complex: the lower lid and upper cheek seen together as one contour.
- Composite rhytidectomy: a deep plane face lift that also repositions the muscle around the eye.
- Orbicularis oculi: the ring muscle around the eye that closes the eyelids.
- Malar augmentation: cheekbone enhancement, such as with implants.
- Lower eyelid retraction: the lower lid edge sitting lower than normal.