Abstract
BACKGROUND: Surgical procedures are required to achieve long-term pretarsal roll fullness of the lower eyelids with a satisfactory appearance. OBJECTIVES: To assess the efficacy of a surgical method using fat grafts for pretarsal augmentation of the lower eyelids. METHODS: We conducted a retrospective clinical study that included 12 Japanese patients (24 lower eyelids) who underwent pretarsal augmentation of the lower eyelids using fat grafts and were followed up for more than 6 months. Morphometric measurements of the projection, width, and area of the pretarsal roll fullness of the lower eyelids were performed. Additionally, surgical outcomes and complications were assessed. RESULTS: Pretarsal roll fullness of the lower eyelids was achieved for more than 6 months postoperatively. The surgery resulted in enlarged eyes with sufficient pretarsal roll fullness, and all patients were satisfied with the aesthetic outcomes. The mean projection (1.6 ± 1.0 vs 0.5 ± 0.6 mm), width (7.4 ± 1.5 vs 4.4 ± 3.6 mm), and area (143.5 ± 42.2 vs 32.8 ± 39.6 mm(2)) of the pretarsal roll fullness of the lower eyelids were significantly greater postoperatively than preoperatively (P < .05). No early postoperative complications were observed during the 6- to 12-month follow-up period. However, overcorrections were observed in 2 cases (16.7%) due to late-onset fat overgrowth, which was corrected by revision surgery. CONCLUSIONS: Fat grafting can help achieve sufficient pretarsal roll fullness of the lower eyelids. The technique presented herein is a simple and reliable alternative surgical procedure for creating pretarsal roll fullness of the lower eyelids.