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Extended transconjunctival lower blepharoplasty safe, effective for tear trough deformity, eye bags

20 Sep 2017
A botched eyelid surgery by suspected fake cosmetic surgeon leaves patient with two differently-shaped eyes

An extended transconjunctival lower blepharoplasty using soft-tissue spaces in the midcheek is both safe and effective for eye bags and tear trough deformity, according to a new study.

The study included 54 patients who received eye bag removal with fat redistribution and tear trough release. Of these, 96 percent (n=52) were primary cases, while a further 53 percent (n=29) underwent lower blepharoplasty together with fat grafting to the midcheek.

Briefly, the surgical procedure first involved removal of excess orbital fat pads from the preseptal space through a transconjunctival incision. The procedure was performed under either local or general anaesthesia.

The following were then sequentially released: the palpebral part of the orbicularis oculi, the tear trough ligament and the orbital part of the orbicularis oculi. This will reveal the levator labii superioris fibres. The medial part of the orbicularis retaining ligament is also released.

The tear trough deformity was then addressed by subsequently grafting the removed fat under the tear trough ligament.

In terms of outcomes, the mean operative time was 42 minutes for the lower eyelid alone, while fat grafting required an additional 25 minutes. Over a mean follow-up period of 10 months, three patients required surgical revisions yielding a revision rate of 5 percent.

Nine percent (n=5) of the patients reported lumpiness of the fat grafts, all of which were resolved spontaneously within 8 weeks. One patient reported a haematoma while another had a corneal abrasion; both cases resolved spontaneously. No cases of chemosis, prolonged swelling, ectropion or eyelid retraction were observed.

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Most Read Articles
Elvira Manzano, 5 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, 2 days ago
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.