Background
Sunken upper eyelid is a commonly found deformity due to the aging process, excessive orbital fat removal, traumatic injury and others. This deformity is frequently accompanied by multiple, poorly defined upper eyelid folds and blepharoptosis. We present our experience of sunken upper eyelid correction for restoration of an adequate amount of soft tissue in the upper eyelid to improve the aesthetic appearance.
Methods
In recent years, more than 200 patients with sunken upper eyelids and a variety of deformities were treated with either surgical or non-surgical treatment according to the severity of the deformity. All procedures were performed by a single surgeon (L.W.C). The outcomes and complications were assessed by evaluating the patients' preoperative and postoperative digital photographs and medical records.
Results
The depression of upper eyelid was basically corrected, and the hollowed symptom of upper eyelid skin were improved without serious complications. Postoperative discomfort included difficulty in eye opening because of the volume of the fat graft and swelling of the periorbita area, which gradually resolved with time. Most of the patients were satisfied with the outcome.
Conclusions
The planning of the treatment including anatomy of the orbit, prior surgical history, and sunken status of the upper eyelid. The brow fat pad, orbital fat transposition flap or HA, fat graft was applied, according to our algorithmic approach based on the severity of the deformity with satisfactory results.

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