Hwang K, Joong Kim D, Chung R S
Department of Plastic Surgery, College of Medicine, Inha University, Inchon, Korea.
Clin Anat. 2001 May;14(3):179-83. doi: 10.1002/ca.1030.
It is generally accepted that there are three infraorbital fat regions in the lower eyelid; medial, central, and lateral compartments. However, removing only the fat in the lateral compartment does not remove the bulge just below the eyelashes, which is caused by another fat pad. The aim of this study was to describe the anatomy of the pretarsal fat compartment and to demonstrate its clinical implications in lower lid blepharoplasty. Ten cadavers (total 20 lower eyelids) were studied. A skin-muscle flap was reflected to expose the soft pretarsal structures. A small stab incision was made on the lateral portion of the sac containing fat on the tarsus. Methylene blue dye was injected into the sac. Specimens were fixed and sagittal sections in four different planes were prepared for histological analysis. The injected dye remained within the sac and demarcated it as a pear or cone shaped structure. This encapsulated fat compartment sits on the lateral half of the tarsal plate above the lateral compartment fat. Auxillary or submuscular fat is well known. This study, however, designates the pretarsal fat as "encapsulated" in a compartment instead of being unbound. We have named it the "pretarsal fat compartment." Histologically, orbital septal fibers separate "pretarsal fat" from lateral infraorbital fat. It is recommended that fat in the pretarsal fat compartment be removed during lower lid blepharoplasty in order to alleviate the bulge or knoll of the skin just below the lower eyelashes.
一般认为下眼睑存在三个眶下脂肪区域，即内侧、中央和外侧隔室。然而，仅去除外侧隔室的脂肪并不能消除睫毛下方的隆起，这是由另一个脂肪垫引起的。本研究的目的是描述睑前脂肪隔室的解剖结构，并展示其在下睑眼袋整形术中的临床意义。研究了10具尸体（共20个下眼睑）。掀起皮肤 - 肌肉瓣以暴露睑前的软组织结构。在睑板上含有脂肪的囊袋外侧部分做一个小的刺切口。将亚甲蓝染料注入囊袋。标本固定后，制备四个不同平面的矢状切片用于组织学分析。注入的染料保留在囊袋内，并将其勾勒为梨形或锥形结构。这个被包裹的脂肪隔室位于睑板外侧半部分，在外侧隔室脂肪上方。辅助脂肪或肌下脂肪是众所周知的。然而，本研究将睑前脂肪指定为在一个隔室内“被包裹”，而不是无边界的。我们将其命名为“睑前脂肪隔室”。组织学上，眶隔纤维将“睑前脂肪”与眶下外侧脂肪分开。建议在下睑眼袋整形术中去除睑前脂肪隔室内的脂肪，以减轻下睫毛下方皮肤的隆起或小肿块。
