ABSTRACT

Background. Plastic and aesthetic surgery is gaining increasing relevance every year. Among patients aged 40 and older, the infraorbital area deserves the most attention, as it requires rejuvenation through surgical intervention-either as a standalone procedure or in combination with upper eyelid peri-orbitoplasty. To achieve radical surgical correction and rejuvenation of age-related changes in the infraorbital area, such as excess skin under the lower eyelids, wrinkling, loss of skin elasticity, and protrusion of fat compartments under the lower eyelids, lower eyelid peri-orbitoplasty is employed. This procedure includes the redistribution of fat pads beneath the lower portion of the orbicularis oculi muscle in the inferomedial, inferolateral, and inferior central directions, followed by their fixation with separate interrupted sutures to the periosteum of the zygomatic bone and the maxilla. Postoperative outcomes have been analyzed in the long-term follow-up period, demonstrating positive clinical results.

Purpose. To analyze the effectiveness of aesthetic and cosmetic outcomes, their stability, and the frequency of postoperative complications in both early and late postoperative periods following lower eyelid peri-orbitoplasty with fat compartment redistribution beneath the lower portion of the orbicularis oculi muscle in inferomedial, inferolateral, and inferior central directions, with fixation of fat pads using separate interrupted sutures to the periosteum of the zygomatic bone and the maxilla. An expert assessment of the aesthetic result was also conducted.

Materials and methods. The study included 45 female patients who underwent lower eyelid peri-orbitoplasty under general anesthesia between 2024 and 2025. The procedure involved incision and excision of a fragment of the lower eyelid portion of the orbicularis oculi muscle, disruption of the ORL (orbicularis retaining ligament), and redistribution of fat pads in the inferomedial, inferolateral, and inferocentral directions. The fat compartments were fixed with separate interrupted sutures to the periosteum of the zygomatic bone and the maxilla. All patients were between 40 and 48 years old. The main motivation for seeking aesthetic surgery in all cases was age-related changes in the soft tissues under the lower eyelids (laxity of the skin, presence of herniated fat pads, and loss of skin turgor).

Results. By the 10th postoperative day, 94% of the patients reported satisfactory cosmetic results. At the two-month follow-up, 98% of all patients expressed satisfaction with the aesthetic and cosmetic outcomes of the procedure.

Conclusion. The results of lower eyelid peri-orbitoplasty with fat compartments redistribution were assessed. The majority of patients noted a positive effect and were satisfied with the cosmetic and aesthetic outcomes of the surgery. Lower eyelid peri-orbitoplasty with fat pad redistribution can be recommended as a priority procedure of choice for correcting age-related changes in the soft tissues of the lower peri-orbital area (xcess skin and presence of fat pads under the lower eyelids).

ABOUT AUTHORS

LITERATURE

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