A Muscle-Based Approach to Superior Orbital Sulcus Hollowness: Preseptal Orbicularis Oculi Flap in Upper Blepharoplasty.
Preseptal orbicularis oculi flap caused transient supraorbital numbness in most patients.
A Muscle-Based Approach to Superior Orbital Sulcus Hollowness: Preseptal Orbicularis Oculi Flap in Upper Blepharoplasty.
Superior orbital sulcus hollowness is a common aesthetic concern that may result from structural changes, trauma, or excessive fat removal during upper blepharoplasty, and it can be further exacerbated by age-related orbital remodeling.
This study evaluated the safety and outcomes of superior orbital sulcus correction using a medial-pedicled preseptal orbicularis oculi muscle flap.
This retrospective study analyzed 481 patients who underwent upper blepharoplasty between January 2017 and June 2024, of whom 45 received additional correction of superior orbital sulcus hollowness with a medial-pedicled preseptal orbicularis oculi muscle flap.
Early postoperative complications, including transient lagophthalmos and edema, were self-limiting.
In the conventional blepharoplasty group, 16 patients developed medial canthal scarring, with four requiring revision.
Statistical analysis using the Mann-Whitney U test demonstrated no significant difference in FACE-Q scores between the two groups (U = 8828.0, p = 0.251).
The medial-pedicled preseptal orbicularis oculi muscle flap appears to be a safe, reproducible, and anatomically sound technique for selected patients with superior orbital sulcus hollowness.
Although the relatively uniform flap volume may not fully correct the deformity in all cases and patient numbers were limited, this method provides a promising alternative to fat grafting without adding long-term complications, with the potential to enhance aesthetic outcomes and patient satisfaction.