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• Other names: Arcus marginalis release, fat mobilization, fat reflection, fat redraping, fat preservation, fat transposition, septal reset.
(For fat injection or free fat grafting, see Fat Injection, Collagen, and Tissue Fillers and Eyelid Hollowness: Fat Grafting)
• Primary goal: Use bulging orbital fat to camouflage a depression at the junction between the lower eyelid and the cheek caused by heredity and/or age-related gravitational descent of the midface.
• Anesthesia: While a wider area of tissue is manipulated, local anesthesia with sedation is adequate.
• Operative technique: Fat repositioning is not so much a distinct operation as it is a different method of handling the bulging fat during a blepharoplasty. The fat pockets may be approached surgically from either a transcutaneous or transconjunctival route, after which they are dissected out of their thin "capsules" but not removed. The fat is then fashioned into a uniform layer still connected to its blood supply. Most typically, this layer is reflected over the rim of bone and advanced into areas of depression, a procedure sometimes called arcus marginalis release with fat transfer. The leading edge of the fat is usually tucked under a small flap of . . . |
