Since many patients with upper eyelid hollowness have undergone previous blepharoplasty, minimizing additional trauma to the eyelid's already disturbed external and internal anatomy is desirable.

Because less tissue disruption tends to correlate with reduced postoperative swelling and bruising, conditions are more favorable for successful revascularization and "take" of the grafted fat.

While the small incision approach has become our technique of choice in most patients with upper orbital hollowness, it cannot be applied in all cases. Some patients who have already undergone multiple previous operations, require skin adjustment or reconstruction of the crease, or suffer from very deep hollowness may not be ideal candidates.