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Effacing the Orbitoglabellar Groove With Transposed Upper Eyelid Fat

Yoo, Donald B. M.D.*; Peng, Grace Lee M.D.; Massry, Guy G. M.D.

Ophthalmic Plastic and Reconstructive Surgery: May/June 2013 - Volume 29 - Issue 3 - p 220–224
doi: 10.1097/IOP.0b013e3182873d65
Surgical Technique
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Purpose: An age-related depression can develop over the superonasal orbital rim, which the authors have called the “orbitoglabellar groove (OGG).” It is, in part, related to volume loss over the rim as is seen at the lower eyelid/cheek interface (nasojugal groove). An upper eyelid fat pedicle can be transposed over the OGG during standard upper blepharoplasty surgery to reduce this depression.

Methods: The charts of patients who underwent fat transposition to the OGG during upper blepharoplasty over a 20-month period (2010–2012) are retrospectively reviewed. Only primary eyelid surgery patients are included in the study. The procedure, its results, and complications are presented.

Results: Seventeen patients are included in this study. Eleven patients (65%) are women and 6 (35%) patients are men. The average patient age is 56 years (range 47–80 years), and the average follow up is 10 months (6–14 months). Two patients (12%) developed a transient induration over the transposed fat pedicle in the postoperative period which resolved with a combination 5-fluorouracil/kenalog injection. There were no cases of postoperative infection, prolonged swelling, motility disturbance, diplopia, or eyelid malposition. Clinical effacement of the OGG was noted in all cases, and physician and patient assessment of surgical results are equally good.

Conclusions: The OGG is an involutional periorbital hollow present over the superonasal orbital rim. The depression can be reduced with native eyelid fat transposition during upper blepharoplasty in a similar way that lower blepharoplasty with fat repositioning effaces the nasojugal groove. The learning curve for the procedure is quick, especially for those who have experience with its lower eyelid counterpart.

The orbitoglabellar groove is a superonasal periorbital hollow present at the brow/upper eyelid junction. Transposing a vascularized eyelid fat pedicle over this area of the orbital rim can reduce the depression.

*Spalding Drive Cosmetic Surgery and Dermatology and Beverly Hills Ophthalmic Plastic Surgery, Beverly Hills; and Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Keck School of Medicine, Los Angeles, California, U.S.A.

Accepted for publication January 4, 2013.

Presented at the annual scientific symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) in Chicago, ILL. Nov 8–9, 2012.

The authors have no financial or conflicts of interest to disclose.

Address correspondence and reprint requests to Guy G. Massry, M.D., 150 N. Robertson Blvd. #314, Beverly Hills, CA 90211. E-mail: gmassry@drmassry.com

© 2013 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.