Sunken Eyelid Correction
Eye socket depression is frequently observed in middle-aged and old patients with eyelid laxity and is mainly caused by atrophy or natural loss of fats in the eyelids due to aging, which thus gives a defective appearance of the eyelids sinking toward the eyeballs. For a minority of patients, it is due to excessive orbital fat removal in a prior double eyelid surgery or inappropriate weight loss that induces premature sinking of the eye sockets. Regardless of the cause, its treatments are available in the following non-surgical and surgical methods in light of the severity of depression or the age of the patient:
Hyaluronic Acid Injection
Autologous Fat Injection
Free Fat Graft
Comparison of Periocular Fat Filling Methods
| Fat injection | Fat graft | |
|---|---|---|
| Ideal candidates | Young patients who have thick skin and early sunken eyes or tear-through groove, male patients | Patients with moderate to severe sunken eyes or tear-through grooves due to aging or combined eyelid skin looseness, female monolid patients |
| Anesthesia method | IV sedation + local anesthesia | IV sedation + local anesthesia |
| Surgical incision | Single injection needle hole at the eyelid | Linear incision on upper or lower eyelid |
| Method for collecting fats | Low-pressure liposuction | Retrieval of intact adipose tissues |
| Incision for collecting fats | Small (approximately 0.5 cm) | Relatively long (approximately 1 cm) |
| Grafting method | Subcutaneous fat injection | Deep layer fat emplacement |
| Concurrent surgery | No | Double eyelid surgery or lower eye bag external incision surgery (lower blepharoplasty) |
| Self-absorption rate | Relatively high (>50%) | Low (<40%) |
| Adipose lump | Probable | Relatively few |
| Fat dislocation | Probable | No |
| Result durability | Relatively short (approximately 2–3 years) | Relatively long (more than 3–5 years) |