A Novel Preoperative Design Utilizing the Rouleau Phenomenon for Sunken Eyelids.

IF 2 3区医学 Q2 SURGERY

Aesthetic Plastic Surgery Pub Date : 2025-07-03 DOI:10.1007/s00266-025-05006-4

Jin Hwang, Tae Hwan Park

{"title":"A Novel Preoperative Design Utilizing the Rouleau Phenomenon for Sunken Eyelids.","authors":"Jin Hwang, Tae Hwan Park","doi":"10.1007/s00266-025-05006-4","DOIUrl":null,"url":null,"abstract":"Background: Correcting sunken eyelids is challenging. This is because the eyelid skin easily moves according to orbital fat volume, making it difficult to predict, which can lead to asymmetrical or unfavorable results. Currently, the preoperative design method for understanding the Rouleau phenomenon and using it to push the lower bag can be helpful as it reduces asymmetry and offers greater predictability. The current study shares our experiences of sunken eyelid correction either by combined upper blepharoplasty and micro-fat grafting. We also introduce our unique preoperative design utilizing the Rouleau phenomenon.Methods: This study included 60 patients who underwent upper blepharoplasty with a fat graft to correct sunken eyelids. It is a retrospective review of 60 cases from August 2021 to April 2023.Results: This study included sixty patients who underwent fat grafting (FG) for sunken eyelid correction and/or upper blepharoplasty (UB) between August 2021 and April 2023. There were nine cases (15%) in which only FG was performed without the need for UB, and 43 cases (71.7%) involved patients who underwent both UB and FG together and achieved aesthetic satisfaction after only one surgery. Revisional surgery was performed when the results were unsatisfactory after the first surgery, which included persistently visible wrinkles, sunken undercorrection, and palpable lumps.Conclusions: We successfully corrected sunken eyelids in the Asian population with a customized approach using fat grafting and/or upper blepharoplasty based on our unique preoperative design utilizing the Rouleau phenomenon. This will assist plastic surgeons in achieving a better aesthetic outcome in this challenging area.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.","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aesthetic Plastic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00266-025-05006-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Correcting sunken eyelids is challenging. This is because the eyelid skin easily moves according to orbital fat volume, making it difficult to predict, which can lead to asymmetrical or unfavorable results. Currently, the preoperative design method for understanding the Rouleau phenomenon and using it to push the lower bag can be helpful as it reduces asymmetry and offers greater predictability. The current study shares our experiences of sunken eyelid correction either by combined upper blepharoplasty and micro-fat grafting. We also introduce our unique preoperative design utilizing the Rouleau phenomenon.

Methods: This study included 60 patients who underwent upper blepharoplasty with a fat graft to correct sunken eyelids. It is a retrospective review of 60 cases from August 2021 to April 2023.

Results: This study included sixty patients who underwent fat grafting (FG) for sunken eyelid correction and/or upper blepharoplasty (UB) between August 2021 and April 2023. There were nine cases (15%) in which only FG was performed without the need for UB, and 43 cases (71.7%) involved patients who underwent both UB and FG together and achieved aesthetic satisfaction after only one surgery. Revisional surgery was performed when the results were unsatisfactory after the first surgery, which included persistently visible wrinkles, sunken undercorrection, and palpable lumps.

Conclusions: We successfully corrected sunken eyelids in the Asian population with a customized approach using fat grafting and/or upper blepharoplasty based on our unique preoperative design utilizing the Rouleau phenomenon. This will assist plastic surgeons in achieving a better aesthetic outcome in this challenging area.

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.

查看原文本刊更多论文

一种利用Rouleau现象治疗下睑凹陷的新颖术前设计。

背景：矫正眼睑凹陷是具有挑战性的。这是因为眼睑皮肤很容易根据眼眶脂肪量移动，很难预测，这可能导致不对称或不利的结果。目前，术前设计方法用于理解Rouleau现象，并使用它来推动下袋可以帮助减少不对称，并提供更大的可预测性。本研究总结了上睑成形术联合微脂肪移植术治疗下睑凹陷的经验。我们还介绍了利用Rouleau现象的独特术前设计。方法：本研究包括60例采用脂肪移植的上睑成形术来矫正眼睑凹陷的患者。这是对2021年8月至2023年4月期间60例病例的回顾性审查。结果：该研究包括60例在2021年8月至2023年4月期间接受脂肪移植（FG）进行凹陷眼睑矫正和/或上睑成形术（UB）的患者。有9例（15%）患者仅行体外移植术而不需要行体外移植术，43例（71.7%）患者同时行体外移植术和体外移植术，仅一次手术即可获得美观满意。当第一次手术后的结果不满意，包括持续可见的皱纹、凹陷的矫正不足和可触及的肿块时，进行翻修手术。结论：基于我们独特的术前设计，利用Rouleau现象，我们通过脂肪移植和/或上睑成形术成功地矫正了亚洲人群的下睑凹陷。这将有助于整形外科医生在这一具有挑战性的领域取得更好的美学效果。证据等级iv：本刊要求作者为每篇文章指定一个证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明www.springer.com/00266。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Aesthetic Plastic Surgery 医学-外科

CiteScore

4.40

自引率

25.00%

发文量

479

审稿时长

3 months

期刊介绍： Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP). Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships. Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.