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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Fat or fillers: The dilemma in eyelid surgery
Giovanni Miotti, Luca De Marco, Davide Quaglia, Martina Grando, Carlo Salati, Leopoldo Spadea, Caterina Gagliano, Mutali Musa, Pier Luigi Surico, Pier Camillo Parodi, Marco Zeppieri
Giovanni Miotti, Luca De Marco, Davide Quaglia, Pier Camillo Parodi, Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
Martina Grando, Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento 33078, Italy
Carlo Salati, Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Leopoldo Spadea, Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, Rome 00142, Italy
Caterina Gagliano, Department of Medicine and Surgery, University of Enna “Kore”, Enna 94100, Italy
Caterina Gagliano, Eye Clinic Catania University San Marco Hospital, Viale Carlo Azeglio Ciampi, Catania 95121, Italy
Mutali Musa, Department of Optometry, University of Benin, Benin 300283, Nigeria
Mutali Musa, Department of Ophthalmology, Africa Eye Laser Centre, Km 7, Benin 300105, Nigeria
Pier Luigi Surico, Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, United States
Author contributions: Miotti G, De Marco L, Quaglia D, Grando M, Parodi PC, and Zeppieri M wrote the outline, did the research, and wrote manuscript; Grando M, Salati C, Spadea L, Caterina Gagliano, Gagliano C, Musa M, and Surico PL assisted in the writing of the paper; Zeppieri M was responsible for the conception and design of the study and completed the English and scientific editing (a native English speaking MD, PhD); Miotti G, De Marco L, Quaglia D, Grando M, Salati C, Spadea L, Gagliano C, Musa M, Surico PL, Parodi PC, and Zeppieri M assisted in the editing and making critical revisions of the manuscript; and all authors provided the final approval of the article.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Marco Zeppieri, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, 15 p.le S. Maria della Misericordia, Udine 33100, Italy. mark.zeppieri@asufc.sanita.fvg.it
Received: March 5, 2024
Revised: April 22, 2024
Accepted: May 11, 2024
Published online: June 16, 2024
Processing time: 91 Days and 1.2 Hours
The aging of the periocular region has always aroused great interest. A fresh, young, and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result. In particular, the change in the concept of a young look, considered then “full”, led to the increasing use of surgical (fat grafting) or medical (hyaluronic acid) filling techniques. Eyelid rejuvenation became increasingly popular in the field of cosmetic treatments, with a focus on achieving a youthful and refreshed appearance. Among the various techniques available, the choice between using fat grafting or fillers presented a clinical dilemma. In particular, what surgery considered of fundamental importance was a long-lasting result over time. On the other hand, aesthetic medicine considered it fundamental not to have to resort to invasive treatments. But what was the reality? Was there one path better than the other, and above all, was there a better path for patients? The minireview aims to explore the physiopathology, diagnosis, treatment options, prognosis, and future studies regarding this dilemma. We analyzed the literature produced in the last 20 years comparing the two techniques. Current literature reveals advancements in biomaterials, stem cell research and tissue engineering held promise for further enhancing the field of eyelid rejuvenation. The choice between fat grafting and fillers in eyelid cosmetic treatments presented a clinical dilemma. Understanding physiopathology, accurately diagnosing eyelid aging, exploring treatment options, assessing prognosis, and conducting future studies were essential for providing optimal care to patients seeking eyelid rejuvenation.
Core Tip: Rejuvenation of the periocular area is an area of interest when attempting to seem younger, which is why non-surgical (hyaluronic acid fillers) and surgical (fat grafting) methods are often considered. The decision between invasive and non-invasive therapies presents a therapeutic challenge for practitioners due to changing views about youthfulness. Fat grafting and fillers have been used over the last 20 years. The physiopathology, diagnosis, prognosis, and future approaches in eyelid rejuvenation are fundamental issues when addressing options for patients. Advances in tissue engineering, biomaterials, and stem cell research provide exciting options for further increasing outcomes in eyelid rejuvenation, which may play a useful role for effective patient care in modern-day eyelid surgery.
