Dr. Dean Toriumi Develops a New Surgical Technique of Soft Tissue Augmentation to Correct the Aging Lower Eyelid

    MARINA DEL REY, CA, January 16, 2010 /24-7PressRelease/ -- As patients age they tend to develop a change in contour to their lower eyelid/cheek area. In many the cheek begins to descend, creating a prominence of the lower eyelid fat pad and a trough or depression between the fat pad and cheek, making patients look even older.

Creating a natural, more youthful look to the aging eye area is important for many patients, and Dr. Dean Toriumi, a noted facial plastic surgeon at the University of Illinois at Chicago, has developed a new technique for lower eyelid blepharoplasty that reverses aging in the eyes. Toriumi has studied the lower eyelid anatomy and has worked to recreate a fuller, more youthful look to the lower eyelid by adding tissue to the deficient areas of the lower eyelid.

This approach to the depression in the eye lower eyelid/check area known as the "tear trough deformity" runs counter to traditional approaches, Toriumi said. In some cases, a surgeon will remove protruding fat pads, a process that can create a flat, aged look to the lower eyelid region. More recently other surgeons have advocated either lifting the cheek or repositioning the prominent fat pad of the lower eyelid, Toriumi added. These are effective surgical techniques, he noted, but both have some drawbacks. Lifting the cheek can be problematic as it can create prolonged postoperative swelling and an unnatural look to the area. Repositioning the fat pad can be highly effective, except few patients have sufficient fat to fill the tear trough deformity.

In some cases, the tear trough can be injected with a material to fill the depression between the cheek and fat pad. This can be very effective to create a smoother transition from the cheek to the lower eyelid fat pad. Unfortunately, there are some problems associated with filler injections in this area, Toriumi said. These problems include irregularities and inadvertent injection of the filler into a blood vessel resulting in vascular compromise, skin necrosis, and rarely blindness. Additionally, many filler materials are not permanent and require periodic re-treatment.

In an effort to avoid these problems, Toriumi has developed a method of treating the lower eyelid tear trough through a combination of repositioning the redundant fat and filling the tear trough with soft tissue such as fascia or soft tissue. "The procedure is performed through a lower eyelid incision made just below the eyelash line," Toriumi said. "Temporalis fascia can be harvested from behind the ear through a small incision and then used to fill the tear trough deformity. If performed in conjunction with a facelift, the temporalis fascia can be easily harvested from behind the ear during the procedure."

"If we are performing a rib cartilage harvest for a rhinoplasty at the same time as the lower eyelid procedure, we can harvest the rib perichondrium and use it to fill the lower eyelid tear trough."

Patients who have dark circles under their lower eyelid area can realize significant improvement by filling the area deep to the dark circles with the white perichondrium from the rib, Toriumi says. The white perichondrium may act to help lighten the darkness of the lower eyelid skin. Patients undergoing this technique will have more swelling than a conventional lower eyelid procedure because soft tissue is added to the lower eyelid, Toriumi said. In most patients, the swelling is significantly reduced in about six weeks, he added.

For more information on facial reconstruction after skin cancer, please call Dr. Dean Toriumi at (312) 255-8812 or email Pat Goldman, RN. at [email protected] or visit our website at http://deantoriumi.com/.

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