Transconjunctival Lower Blepharoplasty Using Midcheek Spaces for Orbital Fat Transposition (S.O.F.T.)

Area of Science:

• Plastic Surgery
• Oculoplastic Surgery
• Facial Anatomy

Background:

• Traditional dissection planes for orbital fat transposition in transconjunctival lower blepharoplasty include subperiosteum, supraperiosteum, and intrasuborbicularis oculi fat.
• The anatomical complexity of these planes presents a steep learning curve for plastic surgeons, potentially limiting procedure adoption.

Purpose of the Study:

• To evaluate the efficacy and safety of utilizing natural midcheek spaces (premaxillary and prezygomatic) as dissection planes for orbital fat transposition.
• To determine if this approach simplifies the transconjunctival lower blepharoplasty procedure and reduces the associated learning curve.

Main Methods:

• A retrospective study analyzed 184 patients undergoing transconjunctival orbital fat transposition using midcheek spaces between November 2013 and July 2019.
• Data collected included patient demographics, surgical duration, postoperative complications, aesthetic outcomes, and patient satisfaction.

Main Results:

• Significant aesthetic improvements were observed in herniated orbital fat, prominent lid-cheek junction, and midcheek depression, with a high patient satisfaction rate (98.91%).
• The average operating time was 46.74 minutes, and no major complications were reported.
• The average follow-up period was 22.41 months.

Conclusions:

• Natural midcheek spaces provide an effective and ideal plane for orbital fat transposition in transconjunctival lower blepharoplasty.
• Employing midcheek spaces simplifies the procedure, making transconjunctival orbital fat transposition a safe and effective technique with a reduced learning curve.