Evaluation of Fat Excision versus Sparing in Lower Blepharoplasty Using Orbital Gray Scale Analysis
Adnan Gamal Etman1, Mohamed Samir Badawy1, Hany Saad Setta1
1Plastic, Burn, and Maxillofacial Surgery Department, Ain Shams University, Cairo, Egypt.
Abstract:
Orbital septum plication provides various benefits, including eliminating the necessity for a septal incision and the ability to relocate infraorbital fat in a more anatomically suitable manner. This study aimed to compare the results of traditional lower blepharoplasty with fat excision and the orbital septal plication method using orbital grey scale analysis as a new objective method for assessment.
Methods:
We conducted a prospective cohort study on patients with bilateral baggy lower eyelids who underwent traditional lower blepharoplasty with fat excision or fat-sparing technique using orbital septal plication. All patients were followed up closely for 1 week and then after 1, 3, and 6 months postoperatively to evaluate the study's outcomes.
Results:
The study was conducted using 40 patients (20 patients per group). The total (medial, central, and lateral) orbital grey scale analysis showed a significant reduction in the fat-sparing and traditional groups (P < 0.001, each). However, the percentage of reduction was significantly higher in the fat-sparing group (34.6 ± 2.9 versus 15.5 ± 3.3 in the traditional groups; P < 0.001).
Conclusions:
The application of the fat-sparing technique is associated with favorable cosmetic outcomes and a lower complication rate than those of the traditional technique with fat excision. Further studies with a longer duration of follow-up and a larger sample size are required to estimate the risk of recurrence and the need for a revision procedure.


