Preoperative volume asymmetry in the upper eyelid sulci can pose a challenge in achieving symmetry after upper eyelid blepharoplasty. Reported methods to improve volume asymmetry include the use of soft tissue filler and various surgical techniques. The authors present 6 cases where a central preaponeurotic fat advancement pedicle was utilized during upper eyelid blepharoplasty for improved upper eyelid symmetry (Fig. 1A-L). No complications or need for postoperative filler or other interventions were noted in all cases, and all patients reported satisfaction with the preaponeurotic fat advancement pedicle procedure. The technique is technically easy, cost-effective, adds minimal operative time to standard upper blepharoplasty, and is associated with high patient satisfaction in this small case series.
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