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One-Piece Orbital Strip Fat Grafts
for Upper Eyelid Hollowness



Note: Over the past year, we have developed a small-incision approach for use in upper orbital fat augmentation that allows a fuller restoration with less anatomical disruption and faster recovery. It is now our procedure of choice and replaces strip fat grafting in the majority of patients with upper hollowness.

While the material below describes strip fat grafting, most of the same principles apply in the small-incision approach to upper orbital fat grafting.



This one-piece strip of fat is generally obtained from a donor area beneath the pubic hair where the fat contains a rich fascial component.

It is implanted behind the intact orbital septum of the upper eyelid as a single piece rather than as a collection of multiple smaller pieces as is done with pearl fat grafting in the lower eyelid.

Normal upper orbital fat exists in precisely this location. In contrast to methods such as superficial needle injection of liposuctioned fat cells under the skin or into the muscle, fasica-fat augmentation occurs at a much deeper but more natural physiologic location.

As a volume enhancer, strip fat is thus superior to injected synthetic or biological materials and provides a smoother contouring for the ovelying skin.

The high fascial component of the graft seems to favor a rapid return of blood supply and also helps to provide a more stable architecture in terms of volume and shape.



Because the graft is placed into the deeper anatomic location naturally intended for fat (the same area from which fat is removed during blepharoplasty), "take" is usually excellent.

When preexisting anatomical conditions allow the strip fat graft to be placed behind an intact orbital septum, graft survival is consistently good (50-70%). Between 2-4 mm of thickness can be added in a single operation. If volume depletion is advanced, a second surgery may be necessary to obtain the best enhancement.

Before and After Photos - Upper Orbital Fat Grafting

Orbital Fat Grafting FAQs

That Tiny Roll of Upper Eyelid Skin



Orbital Fat Grafting
Solutions for Eyelid Hollowness and Collapse



Orbital Fat Grafting Essentials

Overview
Socket Fat and the "Orbital Flat Tire"
Why Fat Injection is Not the Same as Grafting


Treatment Options - An Introduction
Upper Eyelid Hollowness | Lower Eyelid Hollowness
Upper Cheek Hollowness | Preventable Causes

Pearl Fat Grafting | Strip Fat Grafting
Combination Strip-Pearl Fat Grafting Technique
Small Incision Approach

Orbit-to-Orbit Fat Transfer | Internal Orbital Fat Relocation
Dermal Fat Grafts | Fat Injection | Dermal Fillers

Hollowness and Brow Lift | Doll's Eye Deformity
Hollowness in the Asian Upper Eyelid

Healing and Recovery
Sequential Photos from Before to 18 Months After

Removal of Excess Grafted Fat | Dark Circles
What is Meant By Under-Eye Hollows?
Pertinent Anatomy: Diagrams & Definitions

That Tiny Roll of Upper Eyelid Skin (video)

About Dr. Meronk and Eyelid Hollowness
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