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Cohort studyThe Journal of craniofacial surgery · 2026

Application of Autologous Fat Grafting Combined With Orbital Fat Flap Transposition for the Correction of Mild to Moderate Upper Eyelid Hollowing in Double Eyelid Surgery: A 3-Arm Retrospective Controlled Study.

Tao Chen, Xueying Wang, Xiaoqin Liang

OphthalmologyCohort study

Fat grafting plus fat flap transposition linked to greatest eyelid hollowing improvement

Application of Autologous Fat Grafting Combined With Orbital Fat Flap Transposition for the Correction of Mild to Moderate Upper Eyelid Hollowing in Double Eyelid Surgery: A 3-Arm Retrospective Controlled Study.

Tao Chen … Xiaoqin Liang

The Journal of craniofacial surgery · 2026

Purpose

To evaluate and compare the clinical efficacy of orbital fat flap transposition combined with autologous fat grafting, hyaluronic acid injection, or orbital fat flap transposition alone in the correction of mild to moderate upper eyelid hollowing during double eyelid surgery.

Methods

Were allocated into 3 groups according to the surgical approach: group A: orbital fat flap transposition alone (n=47); group B: orbital fat flap transposition combined with autologous fat grafting (n=46); and group C: orbital fat flap transposition combined with hyaluronic acid injection (n=42).

n = 135 patients

Results

Hollowing depth improved 8.07 mm early after surgery, more than other techniques (P< 0.01).

5.45mm

Group A (fat flap alon

7.63mm

Group C (fat flap + HA

8.07mm

Group B (fat flap + fa

More results

During the mid- to long-term follow-up (9-12 mo), the improvement in group A (4.87±0.56 mm) was significantly lower than in group B (7.63±0.67 mm) and group C (6.67±1.45 mm).

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Conclusion · 1 of 2

For patients undergoing double eyelid surgery with mild to moderate upper eyelid hollowing, orbital fat flap transposition combined with autologous fat grafting offers superior correction efficacy, greater stability, and higher patient satisfaction compared with hyaluronic acid injection or fat flap transposition alone.

Conclusion · 2 of 2

This combination may therefore represent a more optimal surgical approach. Notably, some patients in group C reported a localized "water-absorbing swelling sensation," which negatively affected overall satisfaction.

Post

Application of Autologous Fat Grafting Combined With Orbital Fat Flap Transposition for the Correction of Mild to Moderate Upper Eyelid Hollowing in Double Eyelid Surgery: A 3-Arm Retrospective Controlled Study.

Fat grafting plus fat flap transposition linked to greatest eyelid hollowing improvement

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