The Role of Nasal Fat Preservation in Upper Lid Surgery and Assessment With the Face-Q Questionnaire: Innovations in Upper Blepharoplasty

Abstract

Abstract Background Upper blepharoplasty is a common procedure in aesthetic plastic surgery. Numerous techniques focus on removing excessive tissues, including skin, muscle, and fat. However, aging insights suggest tissues mainly undergo depletion rather than increase. Removing significant eyelid fat tissue can boost aesthetics but might result in a gaunt appearance with a recessed superior sulcus. Adjusting this can be achieved by moving a prominent nasal fat pad to the eyelid's center. Objectives We introduce a new surgical method combining the removal of excess skin, minimal resection of the orbicularis muscle, and redistribution of the orbital bags while preserving nasal fat. This method involves minimal detachment, with the medial bag anchored centrally. Methods We conducted a retrospective study on 11 patients eligible for this surgical technique between 2019 and 2023 who underwent preservation upper blepharoplasty. The Face-Q Upper Lid questionnaire was administered both before and 6 months postoperation, with the Face-Q Outcome assessed 6 months after the surgical procedure. Results All participants were females aged between 43 and 68 years. Fat necrosis was absent in all cases. The volume augmentation remained consistent over an average follow-up of 1 year. We recorded zero complications. There was an increase of 25 points in the Face-Q Upper Eyelids score between the preoperative and postoperative stages. The average score for Face-Q Outcome stood at 81.7. Conclusions Our preservation blepharoplasty approach reliably achieves upper lateral eyelid fullness, offering a naturally rejuvenated appearance. Level of Evidence: 5