02/01/2026
Upper Blepharoplasty – Volumetric Contouring Concept 2.0 with Posterior Neck Donor Area
Dr. Nabil Fakih is the inventor of the volumetric contouring concept of the entire orbital rim. He has consistently opposed the routine resection of periocular fat, as excessive fat removal leads, over time, to orbital skeletonization as the patient ages.
He has always advocated for a healthy, natural orbital rim contour, which is achieved by preserving the appropriate amount of fat—a key element in creating aesthetically pleasing eyes. Both excess and deficiency of fat are problematic: excessive fat results in a heavy, tired appearance, while insufficient fat produces a hollowed, skeletonized look.
With a forward-looking, long-term surgical philosophy, acknowledging that patients will continue to age, proper fat preservation and strategic redistribution to recreate harmonious orbital contours offers a far more durable and aesthetic outcome.
This patient represents a complex revision case, having undergone two previous surgeries with another surgeons. The challenge was to completely redesign the orbital contour. Fat was harvested from the posterior neck and strategically redistributed at the retroseptal level, as well as placed along the orbital bony rim using a taco graft technique. Additional work included intervention at the lateral eyebrow region to suspend the orbicularis retaining ligament (ORL), along with several other strategic refinements, including minimal skin excision and correction of a ptotic lacrimal gland and others.
We sincerely thank the patient for her trust and for allowing us to share her before-and-after journey. We are pleased to have been able to improve her outcome through a comprehensive, long-term, volumetric approach.
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📍 🇪🇸 Spain
upperblepharoplasty