Can SOOF Lowering Be Done?
Q: Dr. Eppley, Last year I had a tear trough implant placed with the SOOF lifted over it, combined with lateral canthoplasty and lower lid retraction surgery. I didn’t like the outcome of the surgery and had to receive revision surgery a few months ago. This included removal of the implant, restoration of the canthal angles to a more natural position by using drillhole fixation, and a short horizontal lengthening of the eyelid. The SOOF was also raised again to address any any potential hollowness. I had told the Doctor prior to surgery that I did not want the SOOF raised and wanted it to be back in its original position, and he agreed, but unfortunately did the opposite during surgery. The revision surgery was a huge improvement, however I believe that the SOOF lift has left my undereye/midface area looking bloated and fat. Additionally, the creases under my lower lids have disappeared and so have my love bands. I was wondering if it was surgically possible to return the SOOF to its original position without cutting into the canthal incision site where I had surgery before? Could the SOOF be lowered by a lower eyelid incision? Is the SOOF’s fixation to its new, lifted position permanent?
A: That is an interesting question and the first I have ever heard of a patient requesting SOOF lowering. In theory that should be possible with wide subperiosteal release and letting it just drop. That normally would work in the previously unoperated patient but in the situation where it has been deliberately raised it would have somewhere ‘normal’ to go. But having never done such a SOOF lowering procedure my answer is theoretical and not based on any actual clinical experience.
Dr. Barry Eppley