Upper Eyelid Fat Grafting to Improve Sunken Upper Eyelids! Explained by a Board-Certified Plastic Surgeon.

How to improve

sunken upper eyelids

through upper eyelid fat grafting.

Dr. Kim Jun-hyun of Midline Plastic Surgery explains.

When I saw before-and-after photos

turning into a video somewhere,

I wanted to post it on my blog too,

so I learned how to make an animated GIF from a staff member.

As expected, it is difficult.

^^

I thought '눈두덩' was the standard term,

but I found that '눈두덩이' was also

recognized as a second standard term starting in 2014.

Source: Naver Korean Dictionary

Source: Naver Dictionary

This is before-and-after photos of upper eyelid fat grafting.

If the before-and-after photos move too quickly,

I attached them separately at the very bottom.

Sunken eye fat grafting

If there is no volume around the eyes,

whether above or below the eyes,

the skin tone becomes darker,

making you look older and even tired or gaunt.

Sunken upper eyelids

can make a person look tired,

regardless of their condition or willpower.

On tired days, the sunken upper eyelid area

can become even more pronounced.

First, let’s look at how the fat around the eyes

is divided into different regions.

https://link.springer.com/article/10.1007/s00266-010-9574-y/figures/4

With the septum as the boundary,

the fat behind it that surrounds the eyeball

is called post-septal fat (orbital fat),

https://buism.com/myopia.htm

The fat in front of the septum

is called pre-septal fat. In addition,

the fat in the same layer that lies beneath

the muscle around the eye (orbicularis oculi muscle)

is called ROOF (retro-orbicularis oculi fat).

https://www.dramiyaprasad.net/orbital-fracture-blow-out-medial-wall-fracture-trauma.html

The fat surrounding the eye (orbital fat)

is also the tissue that herniates in orbital fractures.

When the orbit is severely fractured,

the volume surrounding the eyeball is lost,

leading to enophthalmos, as shown in the image below.

https://www.dramiyaprasad.net/orbital-fracture-blow-out-medial-wall-fracture-trauma.html

These orbital fat, preseptal fat, and ROOF structures

around the eyes lose volume as aging progresses.

At the same time, orbital fat descends downward,

which causes a loss of volume above the eyes

and makes the under-eye fat bulge.

https://asps.confex.com/asps/2010am/techprogramcd/paper_17153.htm

In the photo above, the image on the left shows

a young person whose periocular fat has not decreased,

so there is no sunken upper eyelid.

On the other hand, the image on the right shows

fat around the eyes descending and shrinking due to aging,

resulting in a sunken area above the eyes.

A sunken upper eyelid with bulging under-eye fat

But this appearance can occur

due to congenital factors,

even in someone who is not very old,

like the patient in the photo.

How can a sunken upper eyelid be improved?

There is a reason I showed the fat distribution around the eyes above.

If the volume above the eyes has decreased,

the solution is to graft fat back into the eyelid

and restore the lost volume.

The skill of upper eyelid fat grafting

is up to the surgeon, of course.^^

Because the upper eyelid is a special area,

micro fat grafting is performed.

A thinner cannula is also used.

In the paper *Safe and Effective Autologous Fat Graft Augmentation

of the Upper Lid Sulcus:

An Anatomic and Clinical Approach to Rejuvenation* by Erik A. Hoy and others,

there is an image showing the layer where fat is grafted

for upper eyelid fat grafting.

https://asps.confex.com/asps/2010am/techprogramcd/paper_17153.htm

The green-stained area

is where the preseptal fat is located,

and the paper explains that when the stained fat is grafted,

that fat should be placed in that area.

The important part is to finely spread the fat beneath

the orbicularis oculi muscle and graft it there.

The photos below are of a person who underwent

both upper eyelid fat grafting

and under-eye fat repositioning.

Before upper eyelid fat grafting (before under-eye fat repositioning + fat grafting)

After upper eyelid fat grafting (after under-eye fat repositioning + fat grafting)

This has been a look at the causes of sunken upper eyelids

and how they can be addressed.

I’ll be back with more helpful information next time.

<If you have additional questions, please leave a private comment,

and I will kindly answer them. Thank you.>