Correction of palpebral bags and tear trough deformity by orbital fat repositioning through premaxillary and prezygomatic space with intraoral fixation

Abstract

Objective To explore and evaluate the approach of fat repositioning into premaxillary and prezygomatic spaces combined with intraoral fixation in transconjunctival lower blepharoplasty. Methods 17 patients (2 males and 15 females) who underwent this approach from Aug, 2018 to Feb, 2019 were reviewed. Their average age was 36.88±8.80 years old (range, 24 to 55 years old). A 1.0-1.5 cm transverse transconjunctival incision was made. After blunt dissection of premaxillary and prezygomatic spaces, orbital fat were released and sutured with 1-2 absorbable sutures. Via the guidance of astraight needle through the a forementioned spaces, a small incision was made at the upper vestibular labial side. The orbital fat was pulled down according to the consensus between surgeon and patient and fixed upon the small intraoral incision. All incisions didn′t need to be sutured. Results The mean follow up was 3.53±1.71 months (range, 1 to 6 months), transconjunctival and intraoral incisons healed well. Palpebral bags and tear trough deformity were obviously improved. Postoperatively, 2 patients felt a transient tractive feeling in the midface region 1 week after surgery, which spontaneously recovered within 1 to 2 weeks. One patient had red, swollen and painful skin beside the right nasal alar one month after the operation, and the symptoms disappeared after 3-day intravenous infusion of cefradine. No lower eyelid retraction, ectropion, hematoma and other complications were observed. Conclusions This novel approach can achieve periorbital rejuvenation and improve the contour of the lower eyelid and mid-face for patients of all the ages with eyelid bags, tear trough deformity, and midfacial depression, but without severe skin laxity. Key words: Eye bags; Tear trough deformity; Blepharoplasty of lower eyelid; Fat repositioning