Fat Injection as a Valuable Tool for Lower Eyelid Retraction Management: A Retrospective, Observational, Single Blind and Case-Control Study

Combining Deep Plane Face and Neck Lift with Periorbital Rejuvenation and Ancillary Surgical Procedures of the Face: A Critical Evaluation of Over 434 Consecutive Cases

BACKGROUND

Over time, all the face structures inevitably undergo the effects of chrono-aging with changes in their intrinsic characteristics, position and volume. Keeping in mind that all the possible aging defects may be concomitant, in the authors' vision, a careful preoperative evaluation of the patient's aging signs should take consideration of the face as a whole. This study reported the senior author's experience and complications on over 400 patients who consecutively underwent deep plane face and neck lifting combined with periorbital rejuvenation procedures.

MATERIALS AND METHODS

434 consecutive patients who underwent deep plane face and neck lifting combined with periorbital rejuvenation procedures were enrolled in this study. Administration of a subjective/patient-specific and objective surgeon/specific questionnaire allowed to investigate satisfaction level at 12 and 18 months after surgery. Statistical analysis was conducted with Prism9. Surgical drawings, techniques and complications were described.

RESULTS

Data deriving from patients' and surgeons' questionnaires evidenced a high level of satisfaction with the combined surgery. The patients' satisfaction tended to increase, even if with a no statistically significant manner, from 12 to 18 months.

DISCUSSION

Authors outlined the importance of focus the attention also on the correction of the cranial part of the middle third soft tissues aging signs, often "neglected" during facelift, and on the periorbital area.

CONCLUSION

A satisfactory total and harmonious rejuvenation of the face and neck should include a combo surgery combining periorbital rejuvenation procedures with a more "traditional" extended deep plane face and neck lift depending on the aging signs.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Letter in reply to Letter to the Editor: Fat injection as a valuable tool for lower eyelid retraction management: a retrospective, observational, single blind, case-control study

DEAR EDITOR

We have read Dr Riccardo Fondrini and Colleagues commentary on our paper, and we are grateful for their remarks. We herewith would clarify the critical points mentioned about fat reabsorption and survival, along with the risk of periorbital chronic oedema as per the recorded outcomes in the presented case series. Lastly, we have unfortunately to disagree with the commentary's point related to recommended injection depth as it is mandatory to point out that in our experience the superficial injection of nano-fat is a crucial step for lower eyelid retraction management, otherwise a retraction may persist due to the untreated scar in the anterior lamella, thus missing the therapeutic goal that we aim to achieve.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .