Periocular autologous Coleman fat graft survival and histopathology.

ABSTRACT

PURPOSE: Autologous Coleman fat transfer is used in the periocular area and intraorbitally for soft-tissue volume augmentation in postenucleation socket syndrome. This article aims to identify areas of low fat absorption and the histopathology of excised fat. METHODS: Noncomparative case series of patients who underwent excision/debulking of injected autologous fat in the inferior sulcus/lower eyelid. RESULTS: Five of 20 patients with postenucleation socket syndrome who had received intraorbital and sulcus Coleman fat transfer, required fat reduction (sculpting) from the inferior sulcus and lower eyelid due to persistent "overfill" 8 months to 17 months after fat transfer. Between 0.2 ml and 1.4 ml of fat was removed. The excised fat was pale, rubbery, and compact in comparison with the normal lower eyelid fat pad. Histopathology showed healthy adipose cells but with chronic inflammation and fibrous septa. CONCLUSIONS: Fat survival is greater than anticipated in the lower eyelid and inferior sulcus. Therefore, judicious use in these areas is suggested. The grafted fat is distinguishable from the fat in the lower eyelid both clinically and histopathologically.