Three Simple Steps for Refining Transcutaneous Lower Blepharoplasty for Aging Eyelids: The Indispensability of Micro-Autologous Fat Transplantation

Shu Hung Huang, Yun Nan Lin, Su Shin Lee, Yu Hao Huang, Hidenobu Takahashi, Chih Kang Chou, Tsung Ying Lin, Rong Fu Chen, Yur Ren Kuo, Chung Sheng Lai, Sin Daw Lin, Tsai Ming Lin*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

17 Scopus citations


Lower blepharoplasty has been used for rejuvenating lower eyelids, and diverse modifications have been used to treat conjunct deformities at the tear trough/lid-cheek junction. Strategies for recontouring prominent tear trough/lid-cheek junctions, including orbital fat manipulation, have been reported with good results in the literature. Micro-autologous fat transplantation (MAFT) is a previously unevaluated, potentially advantageous approach to blending the prominent tear trough/lid-cheek junction. Objectives: We determined the long-term results after 3-step transcutaneous lower blepharoplasty with MAFT for patients with aging eyelids and prominent tear trough/lid-cheek junctions. Methods: We evaluated 205 patients with aging lower eyelids who underwent transcutaneous lower blepharoplasty with MAFT between October 2010 and September 2016. The 3-step procedure involved a subciliary elliptical skin excision, resection of 3 orbital fat compartments, and MAFT for the tear trough/lid-cheek junction employing a MAFT-GUN under intravenous anesthesia. Results: The mean patient age was 52 years (range, 34-78 years). The mean operating time was 61 minutes. The mean fat volumes delivered to the tear trough/lid-cheek junctions were 2.80 mL and 2.76 mL for the left and right sides, respectively. The average weights of the 3 resected orbital fat compartments were 0.58 g for the left side and 0.56 g for the right side. Patients showed significant improvement and maintenance at an average follow-up of 60.2 months (range, 18-90 months). Conclusions: Three-step transcutaneous lower blepharoplasty with MAFT is an effective, reliable, and promising method with high patient satisfaction and minimal risk of complications. Long-term results demonstrated its utility for aging lower eyelid treatment.

Original languageEnglish
Pages (from-to)1163-1177
Number of pages15
JournalAesthetic Surgery Journal
Issue number11
StatePublished - 15 10 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019 The American Society for Aesthetic Plastic Surgery, Inc.


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