Atrophy of the skin and volume loss are the 2 major contributors to facial aging and affect, early on, the periocular region where they contribute to the formation of periorbital skin wrinkles, thinning and descent of the eyebrows, deepening of the superior sulcus, infraorbital hollowing, and pseudodescent of the cheek.1 In our opinion, facial rejuvenation should target primarily the age-related changes of the periocular aesthetic unit in association with various surgical procedures necessary to address the specific needs of each individual patients. Autologous fat has the potential to provide volume restoration and skin regeneration, and fat grafting is regarded as the procedure of choice for facial rejuvenation. Yet the eyelids are still considered by most surgeons to be off limits for fat grafting because even the smallest irregularity may become visible through the thin eyelid skin, causing unsatisfactory aesthetic results.
Bernardini FP, Gennai A. Fluid Fat Injection for Volume Restoration and Skin Regeneration of the Periocular Aesthetic Unit. JAMA Facial Plast Surg. 2016;18(1):68-70. doi:10.1001/jamafacial.2015.1146