Lower Eyelid Fat Pad Transfer and Upper Eyelid Blepharoplasty for Simultaneous Correction of Tear Trough and Sunken Upper Eyelid Deformities.

BACKGROUND

Frequent coexistence of sunken upper eyelid and tear trough deformities presents a common esthetic concern, yet little attention has been paid to concurrent surgical management of the two conditions.

METHODS

A single-institution retrospective study was conducted on patients who underwent tear trough deformity correction combined with upper eyelid surgery, performed either with isolated orbital fat release or orbital fat release combined with lower eyelid fat transfer. Park's grading and Hirmand classification systems were employed to assess the severity of deformities. The FACE-Q questionnaire was utilized to evaluate changes in patient satisfaction regarding periorbital appearance, psychological well-being, and social function.

RESULTS

A total of 37 female patients were included: 13 in the fat release group and 24 in the fat release with transfer group. The loss to follow-up rate was low (10.8%). Significant improvements in eyelid esthetics and aging appraisal VAS scores were observed in both groups (p < 0.001). Intergroup comparison showed that the fat release with transfer group had greater improvement in upper eyelid appraisal compared with the fat release group (p < 0.05). Minor complications in six eyelids (8.1%) were resolved with conservative management. Overall, most patients were satisfied with the treatment outcome and their decision to undergo surgery.

CONCLUSIONS

Lower eyelid fat transfer provides ideal volume augmentation in patients with moderate to severe sunken deformities. The combined one-stage procedure concurrently addresses two distinct esthetic concerns and avoids additional donor sites, offering a comprehensive approach to enhancing periorbital esthetics in patients with sunken upper eyelid and tear trough deformities.

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