Managing Lower Lid Herniated Fat Pad Without Excision

ABSTRACT

Because of a congenital predisposition and advancing age, the globe may come down, reducing the space between the globe and the orbital floor. Because of the cone-shaped bony orbit, the orbital fat is projected forward, creating a hernia of the lower eyelid no matter how strong the orbital septum may be. Preoperatively, our patients never have excess orbital fat nor do they have shallow orbits, because when we reduce these fat hernias, we never produce an exophthalmia. The orbital fat volume, which will involute with age, is constant in early life. Even if a herniated fat pad appears at an early age, there is no exophthalmia before it manifests itself. A good canthopexy can raise the globe because the Lockwood suspensory ligament is attached to it. This can reduce the herniated fat pad somewhat. We often combine it with the use of the capsulopalpebral fascia attaching it to the orbital rim. We prefer the transconjunctival approach. These methods will delay enophthalmia. We get natural-looking improvements without excising skin or fat pads.

Keywords

Eye rejuvenation - blepharoplasty - aging eye