Correction of Sunken Upper-Eyelid Deformity in Young Asians by Minimally-Invasive Double-Eyelid Procedure and Simultaneous Orbital Fat Pad Repositioning: A One-Year Follow-up Study of 250 Cases.

BACKGROUND Double-eyelid procedure to construct a supratarsal fold is the most common aesthetic surgery in young Asian adults. More complex surgical procedures, such as fat grafting or filler injection, are often indicated during traditional, long-incision, double-eyelid procedures to achieve better aesthetic results for patients with hollowness of the upper eyelids. OBJECTIVES The authors sought to determine the efficacy of minimally-invasive double-eyelid procedures with concurrent repositioning of the orbital fat pads to correct sunken upper eyelids in young Asian adults. METHODS The study included 250 patients treated between June 2008 and July 2103. Preoperatively, all patients complained of upper-eyelid hollowness and had positive findings on a lower-eyelid compression test. All patients underwent a minimally-invasive double-eyelid procedure plus repositioning of orbital fat. RESULTS After the minimum follow-up period of 1 year, the overall patient satisfaction rate was 76%. The relapse rate was 10% within the first year, and the complication rate was 8%. CONCLUSIONS This minimally-invasive combination procedure may be an option for young Asian adults who have single upper eyelids and sunken eyes. The surgery resulted in a natural double eyelid and more youthful orbital appearance in the majority of patients in this study. Proper patient selection and evaluation, including lower eyelid compression testing, are essential to achieve long-term correction.