35-44 year old man treated with Eyelid Surgery

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A 42 years old patient presented in our plastic surgery center requesting improvement of his lower eyelids. He claimed that he had deep-seeded eyes and puffy upper eyelids all his life but he wonted improvement of lower eyelids. He did not like deep groove between cheek and lower eyelid which make him look tired all the time. He did not mind fine wrinkles on the lower eyelid skin.

Clinical examination demonstrated that patient had no redundant skin on the lower eyelids; he had mild bulging of the fat compartments above the groove that made groove look deeper (left).

We performed his lower eyelid surgery in local through incision placed inside of his eyelid. Instead of removing fat pads we transposed them underneath the groove. This small amount of fat tissue provided a filler between bone, muscle and skin and significantly improved the cheek-eyelid groove (tear trough deformity) (right).

His preoperative image (left) demonstrates a visible tear trough deformity (naso-jugal groove); his postoperative image 1 year after surgery, a tear trough is barely visible (right). Notice that there is no scar on his lower eyelids since surgery was performed through transconjuctival incision inside the eyelid. Patient did not have surgery of the upper eyelids.

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