Orbicularis Oculi Muscle Flap Rotation for Correction of Sunken Eyelid in Cosmetic Blepharoplasty

Background: Attempting traditional cosmetic blepharoplasty in a sunken eyelid may cause complications such as multiple folds, irregular or high placement of fold. Additional surgical procedures, such as orbital fat repositioning or free fat grafting, are introduced to correct the sunken appearance. The study sought to introduce a novel orbicularis oculi muscle flap (OOMF) rotation procedure for the correction of the sunken eyelid during blepharoplasty. Methods: Retrospective chart review was performed on patients who presented with sunken eyelid(s) and underwent cosmetic blepharoplasty. All patients underwent OOMF rotation to fill the sunken area during blepharoplasty. Postoperative follow-up ranged from 12 to 15 months the esthetic outcome and complication rates were recorded at each visit. Results: The sunken appearances of eyelids were improved, and smooth double eyelid folds were achieved in all 62 patients (62 females, mean age 24.1 +/- 5.2 years, range: 19-34 years). The mean sunken depths were measured as 6.5 +/- 1.0 mm (range: 5-9 mm) preoperatively, and were improved to 4.2 +/- 0.9 mm (range: 3-6 mm) at the last follow-up visit (P <0.05). At the last follow-up visit, patients rated the surgical result as good in 88.7% (satisfied with the appearance improvement, n=55), fair in 11.3% (mild complaints about the surgical outcome, n=7), and poor in 0 of cases (unsatisfied with the surgical outcome, n=0). Conclusions: In selected patients with sunken eyelid who seek cosmetic blepharoplasty, the OOMF rotation offers a simple and effective way to fill the sunken area and help to form beautiful double eyelids. (c) 2020 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.