{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T10:00:08Z","timestamp":1783764008118,"version":"3.55.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T00:00:00Z","timestamp":1675296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The increasing popularity of fat transfer (FT) to the lower eyelids has led to an increase in unwanted lumps, bumps, and contour irregularities (LBCs). Few studies have addressed the management of LBCs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The aim of this study was to address the management of LBCs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this retrospective review, charts of all patients presenting for evaluation of LBCs following FT procedures to the lower eyelid were reviewed. Clinical characteristics on presentation and surgical findings were evaluated. Patient postoperative clinical course and complications were also documented.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty-eight patients were included (45 women and 3 men), with an average follow-up of 14 months (range, 5-24 months). In 65%, LBCs manifested above the lower orbital rim (AR) and in 35% they were noted AR and below the rim (AR\/BR). The type of contour deficits noted were a solitary nodule (SN) in 54%, a mixed picture (MP) in 23%, diffuse enlargement (DE) in 17%, and multiple nodules (MNs) in 6%. Combining lesion location and type of contour deficit, the most common presentation was an SN-AR in 22 patients (46%), followed by an MP-AR\/BR in 8 patients (17%), and a DE-AR\/BR in 5 patients (10%). Surgical findings revealed that grafted fat is consistently found separate from native eyelid\/orbital fat, and within the orbicularis muscle when AR, and within the orbicularis muscle or the deep suborbicularis oculi fat when BR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>LBCs tend to manifest in characteristic patterns with a predilection for an AR location. Recommendations on the diagnosis and management of these lesions are provided.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjad025","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T08:43:31Z","timestamp":1675327411000},"page":"633-642","source":"Crossref","is-referenced-by-count":6,"title":["The Management of Lumps, Bumps, and Contour Irregularities of the Lower Eyelid and Cheek After Poor Outcome Fat Transfer"],"prefix":"10.1093","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4479-3033","authenticated-orcid":false,"given":"Shoaib","family":"Ugradar","sequence":"first","affiliation":[{"name":"Associate professor, The Jules Stein Eye Institute, University of California , Los Angeles, Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Wang","sequence":"additional","affiliation":[{"name":"Oculoplastic surgeons, Cedars-Sinai Medical Centre , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Patel","sequence":"additional","affiliation":[{"name":"Oculoplastic surgeons, Cedars-Sinai Medical Centre , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John B","family":"Holds","sequence":"additional","affiliation":[{"name":"Oculoplastic surgeon in private practice in Des Peres , MO , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Douglas","sequence":"additional","affiliation":[{"name":"Oculoplastic surgeons, Cedars-Sinai Medical Centre , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Massry","sequence":"additional","affiliation":[{"name":"Oculoplastic surgeons, Cedars-Sinai Medical Centre , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,2]]},"reference":[{"issue":"4","key":"2023051517473810100_sjad025-B1","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/J.FSC.2019.07.001","article-title":"Complications associated with fat grafting to the lower eyelid","volume":"27","author":"Maamari","year":"2019","journal-title":"Facial Plast Surg Clin North Am"},{"key":"2023051517473810100_sjad025-B2","volume-title":"Problems in Periorbital Surgery","author":"Nahai","year":"2018"},{"issue":"2","key":"2023051517473810100_sjad025-B3","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1016\/J.FSC.2021.01.008","article-title":"Transcutaneous blepharoplasty with volume preservation: indications, advantages, technique, contraindications, and alternatives","volume":"29","author":"Jacono","year":"2021","journal-title":"Facial Plast Surg Clin North Am"},{"issue":"4","key":"2023051517473810100_sjad025-B4","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/J.FSC.2021.06.003","article-title":"Lower eyelid and midface rejuvenation: suborbicularis oculi fat lift","volume":"29","author":"Liao","year":"2021","journal-title":"Facial Plast Surg Clin North Am"},{"issue":"2","key":"2023051517473810100_sjad025-B5","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/J.FSC.2021.01.004","article-title":"Transconjunctival lower lid blepharoplasty with and without fat preservation and skin resurfacing","volume":"29","author":"Sarhaddi","year":"2021","journal-title":"Facial Plast Surg Clin North Am"},{"issue":"1","key":"2023051517473810100_sjad025-B6","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.cxom.2017.11.003","article-title":"Complications in fat grafting","volume":"26","author":"Cuzalina","year":"2018","journal-title":"Atlas Oral Maxillofac Surg Clin North Am"},{"issue":"4","key":"2023051517473810100_sjad025-B7","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/J.JCMS.2015.12.013","article-title":"Eyelid fat grafting: indications, operative technique and complications; 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