What Is The Loeb Procedure For Treating Tear Troughs?

Q: Dr. Eppley, I am interested in treating my tear troughs and knowing more about the Lobe procedure for treating them. I already have orbital rim/tear implants in to fix my lower eyelid depressions but they are not quite enough. A plastic surgeon that I consulted with mentioned that I might be a good candidate for the Lobe procedure but didn’t tell me what is was ot how it was done.

A: Fat transposition of the lower eyelid was originally described by Dr. Loeb in 1981 for treating tear troughs. Rather than removing fat from the lower eyelids, he was the first to describe sliding it or moving it over the lower eye socket rim to fill in the tear trough depression. As the tear trough problem has come front and center today, the concept of such fat transposition as taken on a new life and is now very popular. Different techniques have been described for doing it with subtle differences between them. It can be done either through a transconjunctival or open lower eyelid approach. It now has a place in the realm of tear trough treatments which include injectable fillers, fat injections and tear trough/orbital rim implants.