Observation on the Effect of Transconjunctival Lower Blepharoplasty Combined With Orbital Fat Release in Middle-Aged and Elderly Men.

[OBJECTIVE] To explore and evaluate the clinical effect of transconjunctival approach combined with orbital septal fat release in correction of lower eyelid pouch in middle-aged and elderly male patients.

[METHODS] A retrospective analysis was performed on the clinical data of 17 middle-aged and elderly male patients with lower eyelid bags underwent this procedure from December 2022 to December 2023. Age ranged from 40 to 60 years old, with an average of 50.6 years old. A transverse incision with a length of 1.0-1.5 cm was made through the conjunctiva, the orbital fat pedicle was dissociated, and the corresponding premaxillary space and prezygomatic space were separated. The pedicled orbital fat flap was placed horizontally in the above space to fill the lacrimal groove. The orbital fat was fixed on the orbital periosteum with absorbable sutures, which were pulled out from the skin and tied for fixation. All conjunctival incisions were not sutured. Postoperative follow-up was performed, and patient satisfaction was investigated using the visual analog scale to assist in evaluating the clinical effect.

[RESULTS] After a mean follow-up of 5.7 months (range, 3-12 months), the conjunctival incisions healed well in all patients. The lower eyelid bag, tear trough, and palpebral buccal sulcus depression were significantly improved. Satisfaction rate is 94.1% in this study.

[CONCLUSION] The novel technique of using a transconjunctival approach combined with releasing and retaining orbital fat to correct lower eyelid bags in middle-aged and elderly male patients can achieve good results.