Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
Aesthetic Plast Surg. 2019 Jun;43(3):680-685. doi: 10.1007/s00266-019-01309-5. Epub 2019 Feb 7.
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.
We modified the surgical technique of fat-repositioning transconjunctival lower blepharoplasty with an effective but easy internal fixation method via a supraperiosteal approach.
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.
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.
Our modified method of transconjunctival lower blepharoplasty with fat repositioning is safe and effective to improve TTD without severe orbital skin laxity.
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多年来，已有多种技术被用于矫正泪槽畸形（TTD）。经结膜入路的脂肪重置下睑成形术因其令人满意的年轻化效果而得到越来越多的应用。然而，这些方法存在手术入路复杂、残留瘢痕和恢复时间长等缺点。
我们通过经骨膜入路改良了经结膜下脂肪重置下睑成形术的手术技术，采用了一种有效而简单的内固定方法。
2014 年 1 月至 2017 年 12 月，110 例患者接受双侧改良经结膜下脂肪重置下睑成形术。术前根据 Barton 分级系统评估 TTD 程度。在随访期间评估术后结果和并发症。
97.73%的病例 TTD 得到改善；其余 2.27%的病例无改善，经修订后其后均达到 Barton 分级系统的 0 级。所有患者均对最终结果满意。术后并发症少见，无永久性并发症。3 例局部凹陷和 1 例局部隆起采用手术修复。1 例术后出血用电灼治愈。
我们改良的经结膜下脂肪重置下睑成形术治疗 TTD 安全有效，适用于无严重眶周皮肤松弛的患者。
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