The Wannabe Plastic Surgical Clinic, Seoul, Korea.
Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
Aesthetic Plast Surg. 2020 Oct;44(5):1584-1595. doi: 10.1007/s00266-020-01873-1. Epub 2020 Jul 21.
Transconjunctival fat repositioning is the gold standard for the correction of tear trough deformity. For fixation of fat pedicle, the internal fixation (IF) and externalized percutaneous suture (EPS) techniques are used, which have their own advantages and disadvantages. The present study aimed to introduce a new IF technique using a devised needle (EZ-Tcon) and to compare its outcomes with those of the conventional EPS technique.
Patients with primary tear trough deformity who underwent transconjunctival fat repositioning were reviewed and categorized into two cohorts according to the fixation technique: cohort 1 consisted of patients treated using the conventional EPS technique and cohort 2 consisted of those in whom the new IF technique using EZ-Tcon was adopted. Post-operative complications and aesthetic outcomes were assessed using a four-scale grading system.
A total of 545 patients, 211 from cohort 1 and 344 from cohort 2 were evaluated with a median follow-up of 70 days. Compared to cohort 1, cohort 2 showed significantly lower rates of long-standing conspicuous scars on lower eyelid, re-operation and overall complications. In the analysis of aesthetic outcomes, 88.9 percent of cohort 2 showed grade 0 (no deformity) or I (mild deformity) post-operatively. The rate of excellent outcomes (improvements of ≥ two grades) was significantly higher in cohort 2 than in cohort 1 (p-value < 0.001).
Our technique using EZ-Tcon could possess advantages of the conventional IF and EPS techniques, showing lower complication rates and aesthetically satisfactory outcomes, and could be a safe and reliable method of transconjunctival fat repositioning.
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经结膜脂肪重置术是矫正泪槽畸形的金标准。对于脂肪蒂的固定，采用了内固定（IF）和经皮外置缝线（EPS）技术，它们各有优缺点。本研究旨在介绍一种新的 IF 技术，使用一种设计的针（EZ-Tcon），并将其结果与传统的 EPS 技术进行比较。
回顾性分析了接受经结膜脂肪重置术的原发性泪槽畸形患者，并根据固定技术将其分为两组：第 1 组为接受传统 EPS 技术治疗的患者，第 2 组为接受新的 EZ-Tcon IF 技术治疗的患者。采用四级评分系统评估术后并发症和美容效果。
共评估了 545 例患者，其中第 1 组 211 例，第 2 组 344 例，中位随访时间为 70 天。与第 1 组相比，第 2 组患者的下眼睑长期明显瘢痕、再次手术和总体并发症发生率明显较低。在美容效果分析中，第 2 组术后 88.9%的患者为 0 级（无畸形）或 I 级（轻度畸形）。第 2 组的优良结果（改善≥2 级）率明显高于第 1 组（p 值<0.001）。
我们使用 EZ-Tcon 的技术可能具有传统 IF 和 EPS 技术的优势，其并发症发生率较低，美容效果满意，是一种安全可靠的经结膜脂肪重置术方法。
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