Upper Eyelid Fat Excision through a Brow-Lift Incision: An Investigation of Technique and Anatomic Landmarks

Abstract

Introduction: Brow-lift and upper blepharoplasty are often done sequentially to achieve adequate rejuvenation of the upper face. We describe the feasibility of a novel method of addressing both the aged forehead and upper eyelid fat pseudoherniation via an open brow-lift approach. Materials and Methods: We performed our technique on 6 cadaver and 3 human subjects. A brow-lift was performed in open fashion followed by upper eyelid fat excision through the superiorly exposed orbital septum. Position of the orbital fat from this approach and its ease of excision were recorded. Results: In all cases, the medial and central fat compartments were medial and lateral to the supraorbital nerve, respectively. Fat was accessible and amenable to excision from this approach. There were no complications related to this technique. Conclusions: When upper eyelid dermatochalasia is resolved when an open brow-lift is performed, this technique addresses upper eyelid fat pseudoherniation through the same brow-lift incision. Although this procedure is feasible and safe, long-term results in a greater number of patients are needed to confirm its role in aesthetic surgery.