| Objective: Explore the feasibility and necessity of grading blepharoplasty for different types of lower eyelid bulge.Methods: The 73 patients were divided into four types according to the pathological characteristics of the lower eyelid bulge and the severity of the tear trough.Class A patients with simple orbital fat protrusion with HirmandI tear trough;Class B orbital fat protrusion with HirmandII tear trough;Class C: patients with orbital fat protrusion,loose skin and orbicularis oculi muscle,with HirmandI tear trough;Class D: patients with orbital fat protrusion,loose skin and orbicularis oculi muscle,with HirmandⅡ、 Ⅲ tear trough.Class A were given: orbital fat removal through conjunctival approach combined with fat transplantation to fill the tear trough;Class B were treated with tear trough ligment and orbicularis retaining ligament release combined with repositioning of orbita fat through conjunctival approach.Class C were given skin falp blepharoplasty.Class D were given skin-muscle blepharoplasty.Follow-up investigation was conducted on postoperative complications,treatment effect and patient satisfaction.Results: all patients were followed up for 1-6 months after surgery,and no serious complications such as optic nerve injury caused by retrobulbar hematoma,permanent diplopia or hypertrophic scar occurred.Surgical complications included ecchymosis,transient conjunctival congestion and edema,reversible ectropion,inadequate correction of baggy protrusion,temporary diplopia,and bilateral asymmetry.The incidence of postoperative complications was low,postoperative tear trough and skin wrinkles were improved effectively,and postoperative satisfaction of patients was high.Conclusion: According to different types of eyelid bags,graded plastic surgery can effectively improve a series of periorbital aging problems such as orbital fat protrusion,tear trough and lid-cheek juncton.The incidence of postoperative complications was low and postoperative satisfaction was high. |
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