Aesthetic surgical management of the inferior periorbital region should include an approach to volume augmentation of the midface and infraorbital hollow, reduction of fat pseudoherniation in the lower eyelids, and treatment of the overlying skin. A combined approach using volume augmentation with fat grafting, a transconjunctival approach to the lower eyelid fat pads, and conservative management can produce optimal aesthetic results while minimizing complications. The treatment paradigm is to restore volume optimally while minimizing fat resection in the lower eyelids. Volume augmentation is used to restore youthful contours, and to counter deflation and laxity in the periorbital and midfacial regions.
Keywords: Blepharoplasty; Fat grafting; Fat transfer; Lower eyelid surgery; Periorbital rejuvenation; Volume augmentation.
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