Repositioned Orbital Fat Offers More Youthful Look


Giving full credit to Dr. Sam Hamra for introducing the concept of orbital fat preservation in facial aesthetic surgery in 1996, Edward H. Szachowicz, M.D., PhD., called the  transconjunctival blepharoplasty method "a modification"of Dr. Hamara's technique.

Dr. Szachowicz described his approach, which involves opening up the orbital septum withouth removing the fat, to be a "much more sophisticated way to do a transconjunctival blepharoplasty."

Dr. Szachowicz, an assistant professor at the University of MInnesota, said he developed the method in response to the needs of his younger patients, mainly those in their 30's - 40's  who were demonstrating aging, primarily around the periorbital area.

Retain Youthful Look

"The trouble with the traditional transconjunctival blepharoplasty is that, even though the effects on the younger patient are more dramatic initially, it doesn't create an appearance that is youthful or attractive later,"  he said.

The advantage of the modified approach, Dr. Szachowicz said, is that it avoids the hollowing of the orbit and results in a "nonoperated- on, more youthful look."


Dr. Szachowicz said this method overcomes what he considers to be the major disadvantages of traditional transconjunctival blepharoplasty due to fat removal: an orbit that is somewhat more sunken, the skeletonization of the bony skeletal rim, and an excess of skin resulting in more lines and wrinkles.

A disadvantage of orbital fat repositioning is that the recovery time takes longer.

Mild edema is likely to be present for three to six weeks when the fat is preserved.  In addition, Dr Szachowicz said, all patients need to be told to expect a subtle change that will provide lasting benefits over the years, rather than the dramatic fat removal which does not age well.

"The effect of this procedure is more conservative and ultimately more natural looking," he said. "It has become my procedure of choice whenever I consider a patient could benefit from a transconjunctival blepharoplasty." CST

Article by
Minneapolis Facial Plastic Surgeon