Abstract
The periocular area is one of the initial parts of the face that show signs of aging, where patients usually worry about the visual manifestations of aging, such as the sunken lower eyelid. The condition is usually caused by iatrogenic factors or involutional changes in the periocular area. This study aimed to develop and improve surgical methods to fill the sunken lower eyelids and examine their efficacy and safety. This study included 26 patients who had been treated with the musculofascial flap transposition method from the upper to the lower eyelid, under the posterior lamella. In the presented method, a deepithelized triangular musculofascial flap with a lateral feeding pedicle was transposed from the upper eyelid to the lower eyelid tear through depression. In all patients, the method achieved either a complete or a partial elimination of the defect. The proposed method to fill a defect of soft tissues in the arcus marginalis can be considered useful if upper blepharoplasty has not been performed previously and the orbicular muscle has been preserved.