Transconjunctival Lower Eyelid Blepharoplasty with Orbital Fat Repositioning and Orbicularis Oculi Muscle Suspension

To evaluate the therapeutic effect of transconjunctival orbital fat repositioning and orbicularis oculi muscle plication and suspension surgery in patients with lower eyelid aging characterized by lower eyelid bags and tear trough deformities without significant skin laxity.

This study enrolled patients with lower eyelid bags and tear trough deformities. All patients underwent orbital fat repositioning and orbicularis oculi muscle plication and suspension using a transconjunctival approach. Surgical outcomes were assessed based on surgery duration, pain scores, Allergan grading, and patient satisfaction. Additionally, soft tissue changes were evaluated using ultrasonographic imaging.

A total of 40 patients were included in this study. Surgical duration ranged from 28 to 49 min, with intraoperative pain scores between 2 and 4. Ultrasonographic assessment revealed that soft tissue thickness between the skin and the infraorbital rim reached the maximum at 5 days postoperatively, gradually decreasing over time. At 6 months postoperatively, soft tissue thickness remained significantly greater than preoperative levels (P < 0.05). Age group analysis revealed that the 30-40-year-old group exhibited the greatest difference in Allergan scores between postoperative and preoperative periods (P < 0.05). Patient satisfaction 6 months postoperatively was 96.6%.

Transconjunctival lower eyelid blepharoplasty with orbital fat repositioning and orbicularis oculi muscle suspension is an effective surgical approach for correcting lower eyelid bags and tear trough deformities in young and middle-aged patients without significant skin laxity.

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