Modified Lower Blepharoplasty with Fat Repositioning via Transconjunctival Approach to Correct Tear Trough Deformity

Abstract

Background

Over the years, many techniques have been described to correct tear trough deformity (TTD). Fat-repositioning lower blepharoplasty via a transconjunctival approach is increasingly applied due to its satisfactory rejuvenating effect. However, those methods have disadvantages such as a complicated surgical approach, residual scar, and long recovery time.

Objectives

We modified the surgical technique of fat-repositioning transconjunctival lower blepharoplasty with an effective but easy internal fixation method via a supraperiosteal approach.

Methods

From January 2014 to December 2017, 110 patients underwent bilateral modified lower blepharoplasty with fat-repositioning. Preoperatively, the grade of TTD was evaluated according to Barton's grading system. Postoperative results and complications were assessed during the follow-up period.

Results

TTD was ameliorated in 97.73% of the cases; the remaining 2.27% cases with no improvement underwent revision and achieved Grade 0 on Barton's grading system thereafter. All patients were satisfied with the final outcome. Few postoperative complications were observed, none of which led to a permanent condition. Three cases of local depression and one case of local bulge were treated with surgical refinements. One case of postoperative hemorrhage was healed by electrocautery.

Conclusions

Our modified method of transconjunctival lower blepharoplasty with fat repositioning is safe and effective to improve TTD without severe orbital skin laxity.

Level of Evidence IV

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