Guiding Needle-Assisted Redistribution of Orbital Fat in Transconjunctival Lower Eyelid Blepharoplasty.

[BACKGROUND] Accurate fat redistribution after lacrimal trough ligament release by the conjunctival approach is difficult due to the limited surgical field of view. Therefore, creative methods are urgently needed.

[AIMS] To explore an innovative technique focused on fat redistribution using a guiding needle in transconjunctival lower eyelid blepharoplasty to correct tear trough deformity.

[METHODS] Twenty-six patients underwent transconjunctival lower eyelid blepharoplasty. The retroseptal fat was dissected and laid out using a guiding needle for redistribution over the orbital rim. Closing sutures were knotted internally to the periosteum. Patients were followed for 6 months.

[RESULTS] All patients diagnosed with predominant orbital fat bulge and tear trough deformity without noticeable lower eyelid skin laxity presented impressive correction of the eyelid bags and tear trough deformities at 6 months follow-up. The average score for postoperative effect was 5.692 ± 0.618 on a scale of 1-6 (1 being poor and 6 being good).

[CONCLUSIONS] This guiding needle is a simple and effective tool for correcting eyelid bags and tear trough deformities by redistributing orbital fat in the transconjunctival lower eyelid blepharoplasty.