Background Sunken upper eyelids convey an impression of fatigue. Pedicled orbital fat fascia flap (POFFF) transposition has been commonly adopted as an effective technique for augmenting upper eyelid volume. Nevertheless, objective quantitative assessments of the long-term volumetric outcomes remain lacking. This study aimed to assess upper eyelid volume changes and evaluate the efficacy of POFFF transposition in restoring volume using 3D facial scanning technology. Methods This retrospective study included 43 patients (86 upper eyelids) who underwent POFFF transposition between January 2017 and December 2024. 3D facial scanning was performed at baseline (T0), within 5 days (T1), 1 month (T2), and at least 6 months (T3) postoperative using the VECTRA imaging system. Surgical efficacy was evaluated using 3D facial data from T0, T1, T2, and T3, analyzed with GeoMagic Warp for volume change. Fat absorption rate was calculated with GeoMagic Design X. Patients’ reported satisfaction was assessed using the Chinese version of the FACE-Q™ questionnaire scores for eye appearance satisfaction. Results All procedures were successfully performed, with effective three-dimensional correction of the sunken upper eyelids and no major complications. Deviation analysis revealed an immediate postoperative increase in upper eyelid volume. On the left upper eyelid, the volume increased by 223.98±7.01 mm3 at T2 and 197.19±5.97 mm3 at T3 (P<0.05), corresponding to a volume reduction rate of 11.96±2.7%. On the right upper eyelid, the volume increased by 225.77±6.62 mm3 at T2 and 198.67±5.69 mm3 at T3 (P<0.05), with a volume reduction rate of 12.00±3.8%. When considering both eyelids together, the volume increased by 224.87 ±6.84 mm3 at T2 and 197.93±5.85 mm3 at T3 (P<0.05), showing an overall volume reduction rate of 11.98±3.3%.. FACE-Q scores for eye satisfaction significantly improved from 46.50±10.37 to 74.16±9.67 (P<0.05), with all patients expressing satisfaction with their enhanced appearance. Conclusions POFFF transposition effectively increases upper eyelid volume with minimal resorption, providing three-dimensional reconstruction for sunken eyelids. This technique shows promise, especially for patients with mild to moderate upper eyelid sunkenness, though larger studies are needed to determine optimal indications. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.

Efficacy and Outcomes of Pedicled Upper Orbital Fat Fascia Flap Transposition Using 3D Facial Scanning: A Retrospective Study

期刊论文
发表日期：

2026年4月6日

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Kai Yang,
Zhiyang Xie,
Yan Liu,
Jue Wang,
Qiao Yang

摘要

Background

Sunken upper eyelids convey an impression of fatigue. Pedicled orbital fat fascia flap (POFFF) transposition has been commonly adopted as an effective technique for augmenting upper eyelid volume. Nevertheless, objective quantitative assessments of the long-term volumetric outcomes remain lacking. This study aimed to assess upper eyelid volume changes and evaluate the efficacy of POFFF transposition in restoring volume using 3D facial scanning technology.

Methods

This retrospective study included 43 patients (86 upper eyelids) who underwent POFFF transposition between January 2017 and December 2024. 3D facial scanning was performed at baseline (T0), within 5 days (T1), 1 month (T2), and at least 6 months (T3) postoperative using the VECTRA imaging system. Surgical efficacy was evaluated using 3D facial data from T0, T1, T2, and T3, analyzed with GeoMagic Warp for volume change. Fat absorption rate was calculated with GeoMagic Design X. Patients’ reported satisfaction was assessed using the Chinese version of the FACE-Q™ questionnaire scores for eye appearance satisfaction.

Results

All procedures were successfully performed, with effective three-dimensional correction of the sunken upper eyelids and no major complications. Deviation analysis revealed an immediate postoperative increase in upper eyelid volume. On the left upper eyelid, the volume increased by 223.98±7.01 mm³ at T2 and 197.19±5.97 mm³ at T3 (P<0.05), corresponding to a volume reduction rate of 11.96±2.7%. On the right upper eyelid, the volume increased by 225.77±6.62 mm³ at T2 and 198.67±5.69 mm³ at T3 (P<0.05), with a volume reduction rate of 12.00±3.8%. When considering both eyelids together, the volume increased by 224.87 ±6.84 mm³ at T2 and 197.93±5.85 mm³ at T3 (P<0.05), showing an overall volume reduction rate of 11.98±3.3%.. FACE-Q scores for eye satisfaction significantly improved from 46.50±10.37 to 74.16±9.67 (P<0.05), with all patients expressing satisfaction with their enhanced appearance.

Conclusions

POFFF transposition effectively increases upper eyelid volume with minimal resorption, providing three-dimensional reconstruction for sunken eyelids. This technique shows promise, especially for patients with mild to moderate upper eyelid sunkenness, though larger studies are needed to determine optimal indications.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.