This document summarizes a presentation on augmentation lower blepharoplasty with micro-autologous fat transplantation (MAFT) as a new strategy for rejuvenating aging lower eyelids. It provides background on aging lower eyelids and the procedural evolution of lower blepharoplasty techniques. The presentation describes materials and methods used in 442 cases, showing good results with low complication rates and an average surgical time of 50.8 minutes. It discusses benefits of the MAFT technique compared to traditional transcutaneous and transconjunctival approaches, such as blending of the lid-cheek junction and long-term rejuvenation effects. The conclusions state that augmentation lower blepharoplasty with MAFT

1. ⻩黄昱豪 / 林才⺠民
林才⺠民整形外科診所 / ⼤大同醫院 整形外科
2015.03.22(⽇日) 14:10 ~ 14:20 at NTUH
Augmentation Lower Blepharoplasty with Micro-
Autologous Fat Transplantation (MAFT) – A New
Rejuvenation Strategy of Aging Lower Eyelid
2015 台灣外科醫學會

2. Disclosure Deputy Superintedent -
Charming Institute of
Aesthetic and Regenerative
Surgery (CIARS)
Scientific Advisor -
DermatoPlasticaBeauty Co.,
Ltd.
General Educator -
Micro-Autologous Fat
Transplantation (MAFT)

3. 01
02
03
04
Background
Materials & Methods
Results
Discussion

4. Aging Lower Eyelid
Background
~~Neligan Plastic Surgery Volume 2

5. Procedural Evolution
Background
1
…
3
2 Transcutaneous
Transconjunctival
Blending & Integrated
… …

6. Background
Patrick L. Tonnard
Alexis M. Verpaele
Augmentation Blepharoplasty
~~Aesthetic Surgery Journal • 2012

7. Background
?
MAFT for Correction
Sunken Upper Eyelid
~~PRS Global Open • 2014
MAFT for Augmentation
Lower Blepharoplasty??

8. 01
02
03
04
Background
Materials & Methods
Results
Discussion

9. Materials & Methods
90%
10%
x 201
x 20
2014.10
2010.10
2012
0
221Average Age: 53.8 y/o ; Total：442 Lids
Patient Demographics

10. Materials & Methods
Surgical Pearls
• Subcilliary transcutaneous approach
• Adequate skin & muscle excision
• Limited dissection of surrounding tissue
• Minimal removal of herniated fat
• Skin closure & perform MAFT (only 1/240ml)

11. 01
02
03
04
Background
Materials & Methods
Results
Discussion

12. Results
Fat / Eye Right Left
Removed (g) 0.27 0.25
MAFT (ml) 2.59 2.60
Bilateral Lower Eyelids
Average Surgical time:
50.8 min

13. Complication Rate
Results
< 0.05 percent
• Vision Loss
• Early complications
corneal abrasion, infection,
hematoma, chemosis
• Late Complications
dry eyes, lid malposition,
ectropion, lagophthalmos
MAFT Lower
Blepharoplasty
0/442
3/442
2/442

14. 01
02
03
04
Background
Materials & Methods
Results
Discussion

15. Transcutaneous Traditional, safe & efficious
• Maffi et al. and Codner et al.
Low complication rates, no visible scar
• P.K.S. et al.
Blending the lid-cheek junction
Integrated skin resurfacing
• Rohrich et al. & Hidalgo et al.
Augmentation Blepharoplasty
Combined fat grafting
• Tonnard et al.
Discussion
Transconjunctival
Blending & Integrated
Fat Grafting

16. Transcutaneous
Transconjunctival
Discussion
Procedural Evolution

17. Blending & Integrated
Fat Grafting
Discussion
~~Neligan Plastic Surgery Volume 2
• Fat preservation
• Simplified skin excision
• Blending of the lid-cheek
junction & tear-trough
• Resurfacing techniques
Procedural Evolution

18. • Simple transcutaneous approach
• No extended dissection
• Emphasize MAFT
• Compatible complication rates
• Long-term rejuvenation
Discussion
Our Techniques

19. Augmentation lower
blepharoplasty with
Micro-Autologous Fat
Transplantation (MAFT)
is promising & an
alternative method for
lower lid rejuvenation.
Conclusions

20. THANKS … …