Novel Treatment of Pyramidal Multi-Type, Multi-Method, and Multi-Layer (3M) Autologous Fat Grafting Strategy for...

Lower eyelid aging manifests as several distinct issues, including tear trough deformities, eye bags (with or without skin laxity), and infraorbital dark circles. As lower eyelid aging represents a complex and multifactorial problem, the current approaches, relying on a single surgical technique or injection of single product, often yield unsatisfactory results. The present study describes a simplified strategy utilizing fat derivatives transplantation: the Pyramidal Multi-type, Multi-method, and Multi-layer (3M) strategy. This approach achieved favorable outcomes by simultaneously addressing all these lower eyelid aging problems.

This study included 53 patients (106 sides), with a median follow-up of 15.5 months (range from 6 to 24 months). All patients received Pyramidal 3M fat grafting for lower eyelid aging by deep transplantation of macrofat, superficial transplantation of microfat or microfat/superficial enhanced fluid fat (SEFF), and subdermal transplantation of nanofat or stromal vascular fraction (SVF). We retrospectively analyzed the histories and photographs of patients who underwent Pyramidal 3M fat grafting for lower eyelid aging. Patients were followed up before and 6 months after the treatments by modified Goldberg scale and subject satisfaction assessment (SSA) scale.

Only mild adverse effects such as mild edema and transient ecchymosis were observed, occurring in 3.8% of patients. More severe complications like infections, calcification, fibrosis, fat liquefaction, visible grafts, occlusion of the ophthalmic artery, or vision loss were not encountered in any participants. 11 patients (22 sides) underwent revision surgery 3-6 months after the initial procedure due to suboptimal outcomes. Both the Goldberg scale and SSA scale demonstrated statistically significant improvements to varying degrees.

The Pyramidal 3M autologous fat grafting strategy provides a convenient, effective, and safe solution for infraorbital rejuvenation in middle-aged patients, with rapid recovery. This technique effectively addresses tear trough deformities, mild eye bags (without skin laxity), and dark circles.

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