Application of Orbital Septal Fat Repositioning Combined With SVF-Gel Fillers in Lower Blepharoplasty

BACKGROUND: Lower blepharoplasty is a widely used cosmetic surgical procedure to improve under-eye bags and tear trough deformities, aiming to enhance facial aesthetics and achieve a more youthful appearance. The formation of these deformities is often associated with factors such as aging, skin laxity, and fat displacement. Traditional surgical methods include orbital septal fat repositioning and fat grafting, each with its own advantages and limitations. Transconjunctival blepharoplasty avoids external incisions by performing the surgery through the conjunctiva, thereby reducing postoperative scarring and recovery time. However, orbital septal fat repositioning alone is often insufficient to completely address issues of inadequate orbital septal fat and lax tear trough ligaments. Therefore, a combined approach of orbital septal fat repositioning and SVF-gel injection has been proposed to achieve more lasting and satisfactory results. OBJECTIVE: This study aims to investigate the advantages and rationality of combining orbital septal fat repositioning with SVF-gel injection in lower blepharoplasty, to assess the improvement in tear trough deformities and lower eyelid skin quality, to define its indications, and to achieve personalized treatment. METHODS: This study involved 42 patients who underwent transconjunctival blepharoplasty combined with fat repositioning and SVF-gel injection from January to December 2023. The surgical steps included donor site selection, fat harvesting, SVF-gel preparation, blepharoplasty, and SVF-gel injection. Postoperative follow-ups were conducted to evaluate the effectiveness and complications through gray value measurements and patient satisfaction surveys. RESULTS: The study results demonstrated that 92.9% of patients were very satisfied with the surgical outcomes, with only 2.4% of patients experiencing mild tear trough indentation postoperatively. Gray value measurements indicated a significant improvement in postoperative gray values, suggesting a reduction in lower eyelid pigmentation. CONCLUSION: This study confirms that the combined use of orbital septal fat repositioning and SVF-gel injection can effectively improve tear trough deformities and lower eyelid skin quality, enhancing patient satisfaction. This combined technique demonstrates good adaptability and long-lasting effects, providing new options for personalized treatment. Further research is needed to optimize the surgical techniques and long-term outcomes.