Objective To provide anatomical basis for the replacement of eyebrow fat pad to improve the blepharoplasty of upper eyelid skin ptosis. Methods The eyebrow regions of 14 fresh frozen cadaver heads were dissected. The important adjacent relationship and anatomical parameters of eyebrow fat pad were recorded and measured. Results The eyebrow fat pad was located in the fascial fat layer between the frontalis muscle, the orbital part of the orbicularis oculi muscle and the periosteum, and it was closely connected with the orbicularis oculi muscle. While the connection between eyebrow fat pad and periosteum and orbital diaphragm was loose. The eyebrow fat pad gradually thinned upward to a fascia state, and moved downward into the fat layer under the orbicularis oculi muscle The medial side was the supra-trochlear neurovascular bundle, which continued outward with the fat layer of the superficial temporal fascia, showing a flat oval shape with a long transverse diameter. The mapping range on the body surface was located in the peak and tip of the eyebrow. The maximum thickness, vertical width, and horizontal length of eyebrow fat pad were (1.33±0.30) mm, (15.51±0.53) mm, (34.44±0.67) mm. Its main blood supply came from the branches of the supraorbital artery to the temporal side. The eyebrow fat pad formed a sliding space between the orbital septum and the muscle, which was conducive to eyebrow movement, but it would cause the lateral eyebrow to have insufficient support against gravity, resulting in the lateral orbital soft tissue sagging with the increasing of age. Conclusions The skin ptosis of the upper eyelid can be improved by replacing the eyebrow fat pad and fixing it on the periosteum of the orbital margin, which can not only adjust the position of the eyebrow, but also enhance the supporting structure of the soft tissue above the orbital margin, avoid the appearance of eyebrow ptosis, stabilize the surgical effect and improve the morphology of eyebrow and upper eyelid.
Key words
Anatomy; /
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Eyebrow fat pad; /
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Upper eyelid plastic surgery; /
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Suspension fixation; /
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Upper eyelid skin relaxation
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