| Objective To study the surgical method of dermal fat autograft for correcting the deepened superior sulcus after the orbital implant of hydroxyapatite(HA).
Methods 22 patients of mild deepened superior sulcus (with a depth ≥ 2mm, ≤4mm for the depressed sulcus) caused by the fat atrophy in the orbit after the HA implant, excluding the dislocation of HA and orbital fracture, received the dermal fat harvest surgery with a graft size of 3.0cm long, 2.0cm high, and 0.5～0.8cm thick at the position of anterior supra iliac crest. The orbital septums were opened after a blepharoplasty incision, and the autografts were fixed at the superior edge of upper tarsal plates at the approximate layer same as orbital septum. The patients were observed for 2～26m, with the average of 9.2m. The inflammation of the transplantation areas, position of upper eyelids, morphology of superior sulcus, mobility of HA implants and bilateral exophthalmos levels were recorded, with the contrast of pre- and post-surgery.
Results There were no ptosis, conjunctival sac deformity or inflammation for both donor and recipient sites after the surgery. Additionally, the motility of the prostheses was good. The situation of deepened superior sulcus in all cases was improved after the surgery within 3m. Due to the gradually absorbed graft fat beneath the skin after 3m, 3 patients remained mild but improved deepened superior sulcus, 3 patients seemed almost no improvement, while 16 other patients obtained relatively acceptable correction.
Conclusions Dermal fat autograft may be a safe and practical option to bring about a good cosmetic effect the mild deepened superior sulcus after the orbital implant of HA. |
