Article Text

Download PDFPDF

Raising the suborbicularis oculi fat (SOOF): its role in chronic facial palsy
  1. Jane M Olver
  1. Western Eye Hospital, Marylebone Road, London NW1 5YE and Eye Department, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
  1. Western Eye Hospital, Marylebone Road, London NW1 5YE, UK JaneOlver{at}


AIMS To determine the adjuvant role of unilateral suborbicularis oculi fat (SOOF) lift in the periorbital rehabilitation of patients with chronic facial palsy.

METHODS In a non-comparative prospective case series nine adult patients (seven male, two female) aged 34–90 years (mean 60.5) with chronic unrecovered facial palsy (over 1 year), who had not had any previous rehabilitative periorbital surgery, were studied. Lateral tarsal strip and adjuvant transconjunctival approach subperiosteal SOOF lift under local or general anaesthesia were performed; medial canthoplasty was performed where indicated. There was clinical observation of the long term (over 1 year) effect on the ptotic palpebral-malar sulcus and lower eyelid retraction.

RESULTS The patients were followed up for 12–24 months (mean 16). Seven patients (77%) had sustained clinical reduction of palpebral-malar sulcus ptosis. All patients had sustained reduction of lagophthalmos. Early postoperative complications included conjunctival cheimosis in 77%. Three patients with persistent keratitis required further surgical procedures on their upper eyelid to reduce the palpebral aperture. There were no cases of infraorbital nerve anaesthesia or recurrent lower eyelid retraction.

CONCLUSIONS The SOOF lift has an adjuvant role in chronic facial palsy with lower eyelid retraction and ptotic-palpebral malar sulcus. It supports the lower eyelid elevation and tightening achieved with the lateral tarsal strip. The best results were obtained in congenital facial palsy.

  • facial palsy
  • suborbicularis oculi fat
  • subperiosteal mid-face lift
  • lagophthalmos
View Full Text

Statistics from


    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.