Transcutaneous Lower Blepharoplasty with Midface Lift by Malar Fat Suspension to Lateral Part of Infraorbital Wall.

[BACKGROUND] The anatomy of the eyelid changes with age. Multiple changes were observed in the eyelids and the surrounding structures including the malar region. Aging affects the appearance of eyelids and midface by the formation of tear trough deformity and malar flattening and ptosis. To define the effect of malar fat suspension on the lateral part of the infraorbital wall and orbital fat transposition in tear-trough and malar flattening and ptosis.

[METHODS] A retrospective study was carried out on 15 patients who had surgeries between January 2020 and January 2022. This technique combines orbital fat transposition to the medial side of the infraorbital wall and malar fat suspension to the lateral side of the infraorbital wall. The average follow-up period was 12 months. Values were compared by paired samples student or Wilcoxon signed rank test for quantitative and qualitative data respectively.

[RESULTS] There was a significant improvement in tear trough deformity, malar ptosis, and midface lift ( < 0.5). No recurrence was observed on follow-up of 12 months. One patient experienced minor postoperative complications in the form of prolonged ecchymosis for 2 months.

[CONCLUSION] The transcutaneous lower blepharoplasty with orbital fat transposition and malar fat suspension to the lateral part of the infraorbital wall can be considered a safe and effective intervention with improved aesthetic outcome. Thus, it is recommended in patients with tear trough deformity and malar ptosis.