A New Method of Lower Eyelid Blepharoplasty with Tear Trough Deformity and Mid-face Rejuvenation: Elevating Suborbicularis Oculi Fat and Suturing the Orbital Septum and Orbital Fat as a Whole for Fixation.

[OBJECTIVE] Exploring the clinical effects of the method using elevating the suborbicularis oculi fat (SOOF) and suturing it with the orbital septum and orbital fat as a whole for fixation to correct lower eyelid bags and tear trough deformities.

[METHODS] A retrospective analysis was conducted on clinical data of patients who underwent transcutaneous lower eyelid blepharoplasty at Hunan Provincial People's Hospital from January 2019 to January 2021. The method involved elevating the suborbicularis oculi fat and suturing it with the orbital septum and orbital fat as a whole for fixation to correct lower eyelid bags and tear trough deformities, and follow-up to evaluate the correction of eyelid bags, tear troughs, and mid-face ptosis, as well as patient satisfaction.

[RESULTS] A total of 132 patients (264 eyes) were included in the study, with 178 eyes having type II tear trough deformity and 86 eyes having type III tear trough deformity. Eyelid bags disappeared in 252 eyes and were alleviated in 12 eyes. Among the eyes with type III tear trough deformity, 10 eyes transformed into type I tear trough, while the remaining 76 eyes with type III tear trough deformity and all 178 eyes with type II tear trough deformity showed complete disappearance of tear troughs after the surgery (p < 0.01).. Improvement in mid-face ptosis was observed in all 264 hemifaces, as the vertical distance from the nasolabial cheek fat prominence point to the lower eyelid margin decreased significantly after the surgery (p < 0.01). Satisfaction evaluation revealed 118 patients with satisfaction (satisfaction rate of 89.4%), 14 patients with basic satisfaction, and no dissatisfied patients.

[CONCLUSION] The method of elevating the suborbicularis oculi fat and suturing the orbital septum and orbital fat as a whole for fixation to achieve correction and rejuvenation of the lower eyelid and mid-face is a reliable method for achieving the desired effect.

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