Correction of Superficial Tear Trough Deformity with Autologous Septal Fascia Graft During Lower Blepharoplasty.

Residual tear trough deformity (TTD) often persists after standard lower blepharoplasty because of the significant difference in skin thickness between the thin lower eyelid and thicker midface. Current treatments, such as dermal fillers or nanofat grafting, face limitations, including potential surface irregularities, the Tyndall effect, and the need for additional donor sites. This article introduces autologous septal fascia grafting as a novel technique to correct superficial TTD during lower blepharoplasty. The procedure involves harvesting a strip of the orbital septum according to the severity of the preoperative deformity using the same blepharoplasty approach, eliminating distant donor-site morbidity. This linear graft is threaded into the subdermal layer of the tear trough to structurally augment skin thickness and soften the eyelid-cheek junction. Clinical outcomes demonstrated stable improvement of superficial TTD without hypertrophic scarring, contour irregularities, or the Tyndall effect, offering an efficient and durable solution for transition zone camouflage.