Satisfaction Survey And Retrospective Study On The Impact Of Transconjunctival Orbital Fat Reposition On “the Tear Trough And Palpebromalar Groove”

Objective: The aim of this study was to conduct a retrospective analysis on the patients undergoing transconjunctival fat repositioning,which is one kind of surgery of lower lid blepharoplasty,and trying to explore an objective method evaluating the improvement of the“tear trough and palpebromalar groove”,and to research the change of the “tear trough and palpebromalar groove”.Methods: Retrospectively analysis 41 patients undergoing transconjunctival fat repositioning in plastic and reconstructive surgery in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from March 2017 to March 2019.Only patients with preoperative and at least 4 months postoperative standardized photos were included.Satisfaction surveys on the improvement of the “tear trough and palpebromalar groove” were conducted on the patients by telephone.All the pictures of the patients before and after the operation were imported into Photoshop CS4.Draw a vertical line passing the inner canthus and a horizontal line with the inner canthus as the origin,measuring the minimum distance from end point of the “tear trough and palpebromalar groove” to the vertical and horizontal line and measuring the minimum distance from the lowest point of the “tear trough and palpebromalar groove” to the vertical and horizontal line.Form a closed area with a horizontal line in the half-way from inner canthus to the nasal base,the vertical line passing by the inner canthus,the vertical line passing by the outercanthus,and the line between the inner canthus.Also the fixed area was divided horizontally as four equal parts,and divided vertically as four parts by four vertical lines through the pupil center,the lateral limbus and the medial limbus respectively.Every square was marked with a letter or number.The length from end point of the “tear trough and palpebromalar groove” to the vertical and horizontal line were devided by the lengh and width of the fixed area.The length from the lowest point of the “tear trough and palpebromalar groove” to the vertical and horizontal line were devided by the length andwidth of the fixed area.4 ratios were counted in each eye.Each value was accurate to three digits after the decimal point.Results: The overall satisfaction rate about the improvement of the “tear trough and palpebromalar groove” was 90.2% in the patients undergoing transconjunctival fat reposition.The distribution of bilateral “tear trough and palpebromalar groove” was basically symmetry.The line chart of bilateral “tear trough and palpebromalar groove” moved to the left by an interval,and the number of patients in the end of the chart line decreased.The probability that the end point of the “tear trough and palpebromalar groove” located outside the midline of the pupil decreased from 95.1% to 64.6%,felling by 30.5%.Contour analysis showed that there is significant difference in the “tear trough and palpebromalar groove” obtained between the preoperative group and postoperative group(the right side F = 79.844,P = 0.000<0.01;the left side F = 161.799,P = 0.000 <0.01).The contour line of the “tear trough and palpebromalar groove” of the two groups did not overlap.After this operation,the ratio of the vertical distance which is from the lowest point of the “tear trough and palpebromalar groove”to the line between the inner canthus to the vertical width of the fixed area(low v)declined.The ratio of the horizontal distance which is from the lowest point of the “tear trough and palpebromalar groove” to the vertical line passing through the inner canthus to the horizontal length of the fixed area(low h)declined.The ratio of the vertical distance which is from the end point of “tear trough and palpebromalar groove” to the line between the inner canthus to the vertical width of the fixed area(end v)reduced.The ratio of the horizontal distance which is from the end point of the “tear trough and palpebromalar groove” to the vertical line passing through the inner canthus to the horizontal length of the fixed area(end h)reduced.Conclusions: After transconjunctival fat reposition,the line chart showed that the “tear trough and palpebromalar groove” moved upward and the length of it became shortened,contour analysis showed that the lowest point and end point of the “tear trough and palpebromalar groove” both moved inside and upward.These included patients were satisfied with the treatment of the “tear trough and palpebromalar groove”.Transconjunctival fatreposition could improve the “tear trough and palpebromalar groove”,then the lower eyelids were rejuvenated.