Li Wei, Zhang Yange, Huang Shangyang, Xu Xuewen, Xiao Haitao
Department of Plastic and Burns Surgery, West China Hospital, Sichuan University, 37 Guoxuexiang, Chengdu, 610041, China.
Aesthetic Plast Surg. 2025 Feb 5. doi: 10.1007/s00266-025-04704-3.
After the introduction of orbital septal fat release and reposition in transconjunctival lower blepharoplasty (TCLB), few studies have addressed the thorough release of orbital fat tissue to adequately augment the tear trough and midface concavity. Additionally, limited literature exists regarding residual or recurrent eye bags and corresponding preventive measures after fat release and repositioning in TCLB.
From December of 2021 to May of 2023, 105 patients were treated with the full integration and repositioning of orbital septal fat tissue (F.I.R.S.T.) technique in TCLB. This study observed the effectiveness of correcting tear trough deformity (TTD) and midcheek depression using the technique, and we have documented all complications, especially the residual eye bags.
This mean age was 34 years (range: 19-54 years) with a mean follow-up of 13 months (range: 3-17 months). The average operation duration was 55 ± 7.1 minutes (range: 45-89 mins). Among the cases, 70 eyes (33.33%) had Grade I TTD, 92 eyes (43.8%) had Grade II TTD, and 48 eyes (22.9%) had Grade III TTD. Successful correction was achieved in all Grade I cases, with 75 eyes (81.52%) improving to Grade 0 among Grade II cases. For Grade III cases, 28 eyes (58.33%) improved to Grade 0. Our technique has significantly improved the tear trough area for nearly 2 mm. Only one patient complained about fat residual and no patients had relapses.
The F.I.R.S.T. technique effectively prevents fat residual in the lower eyelid area and provides favorable postoperative filling effects in the tear trough and midcheek region.
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在经结膜下睑袋整复术（TCLB）中引入眶隔脂肪释放与重置后，很少有研究探讨对眶脂肪组织进行充分释放以有效改善泪沟和中面部凹陷的问题。此外，关于TCLB中脂肪释放与重置后残留或复发性眼袋及相应预防措施的文献有限。
2021年12月至2023年5月，105例患者接受了TCLB中的眶隔脂肪组织完全整合与重置（F.I.R.S.T.）技术治疗。本研究观察了该技术矫正泪沟畸形（TTD）和中面部凹陷的有效性，并记录了所有并发症，尤其是残留眼袋。
平均年龄为34岁（范围：19 - 54岁），平均随访13个月（范围：3 - 17个月）。平均手术时长为55 ± 7.1分钟（范围：45 - 89分钟）。病例中，70只眼（33.33%）为I级TTD，92只眼（43.8%）为II级TTD，48只眼（22.9%）为III级TTD。所有I级病例均成功矫正，II级病例中有75只眼（81.52%）改善至0级。III级病例中，28只眼（58.33%）改善至0级。我们的技术使泪沟区域显著改善了近2毫米。仅1例患者抱怨有脂肪残留，无复发患者。
F.I.R.S.T.技术有效防止下睑区域脂肪残留，并在泪沟和中面部区域提供良好的术后填充效果。
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