Wills Eye Hospital, Division of Oculoplastics, Philadelphia, PA.
UCLA Stein Eye Institute, Division of Oculoplastics, Los Angeles, CA.
Aesthet Surg J. 2020 Aug 14;40(9):938-947. doi: 10.1093/asj/sjz345.
The tear trough is a prominent structure of the midface. Many surgical and nonsurgical techniques have been devised to efface this feature.
The aim of this study was to define an aesthetically pleasing tear trough and understand the effect of various surgical procedures on its appearance.
We undertook a retrospective review of "ideal" subjects (ie, young men and women as well as male and female models) as well as surgical patients undergoing lower blepharoplasty with fat excision, fat transposition, erbium laser resurfacing of the eyelids and midface, or endoscopic midface lifting. Marginal reflex distance-2, lower eyelid length, and nasojugal fold depth were measured and analyzed for all patients.
The nasojugal fold was significantly less prominent in ideal female models than in all other groups (P < 0.0001). Lower eyelid length was significantly shorter after fat excisional lower blepharoplasty, laser resurfacing, and midface lift (P < 0.0001), and did not change after fat transpositional lower blepharoplasty. Postsurgical reduction in lower eyelid length was significantly less with fat transpositional lower blepharoplasty than in all other groups (P < 0.0001). The nasojugal fold was significantly effaced after all types of procedures (P < 0.0001), but was significantly more effaced after fat transpositional lower blepharoplasty (P < 0.01) than after all other procedures.
A slight, medial tear trough is present in youth in many patients. The clinical tear trough is a virtual topographic structure distinct from the anatomic tear trough ligament and can be altered in a variety of ways.
泪槽是中面部的一个明显结构。许多手术和非手术技术已被设计用于消除这一特征。
本研究旨在定义一个美观的泪槽，并了解各种手术程序对其外观的影响。
我们对“理想”的受试者（即年轻男女以及男性和女性模特）以及接受下眼睑脂肪切除、脂肪移位、铒激光眼睑和中面部重塑或内窥镜中面部提升的下眼睑整形手术患者进行了回顾性研究。对所有患者测量并分析了眶下裂距离-2、下眼睑长度和鼻颊褶皱深度。
理想女性模特的鼻颊褶皱明显比其他所有组都不明显（P < 0.0001）。脂肪切除性下眼睑整形术后、激光重塑术后和中面部提升术后下眼睑长度明显缩短（P < 0.0001），而脂肪移位性下眼睑整形术后下眼睑长度不变。与所有其他组相比，脂肪移位性下眼睑整形术后下眼睑长度的术后减少明显较少（P < 0.0001）。所有类型的手术都能明显消除鼻颊褶皱（P < 0.0001），但脂肪移位性下眼睑整形术后的效果明显优于所有其他手术（P < 0.01）。
许多患者在年轻时都有一个轻微的、内侧的泪槽。临床泪槽是一个虚拟的地形结构，与解剖泪槽韧带不同，可以通过多种方式改变。
