Analysis Of The Efficacy Of Modified Lower Blepharoplasty In The Treatment Of Eyelid Bags In Middle-aged And Elderly People

Objective:To analyze the clinical curative efficacy of lower blepharoplasty combined with orbital septal fat release in the treatment of eyelid bags in middle-aged and elderly people,and to provide reference for the clinical application of plastic surgery in the treatment of eyelid bags in middle-aged and elderly people.Methods:A retrospective analysis of the cases of patients with lower eyelid bags admitted to the plastic surgery outpatient department of our hospital from September2019 to December 2021.According to the inclusion and exclusion criteria,a total of60 cases meeting the research criteria were finally screened out,and they were divided into observation group and control group according to different surgical methods,and in each group,the lacrimal groove depression was graded according to Barton’s method before operation;The observation group was treated with lower blepharoplasty combined with orbital septal fat release in which suturing of the orbital septum and fixation of the external canthus with appropriate amount of excess skin removed through a skin approach to release the supporting ligaments of the orbicularis oculi and the lacrimal groove ligaments in 30 cases.The control group was operated with classical external lower blepharoplasty by removal of excess fat and loose skin through a skin incision in 30 cases.Before the operation need to take the patient’s face frontal photos and conduct a specialist examination,explain the precautions and postoperative care,and improve relevant inspections.The clinical efficacy,tear trough depression,lower lid wrinkle and tarsal orbicularis oculi score,postoperative complications,operation time,lower lid appearance recovery time,and patient satisfaction in the observation and control groups at 3 afteroperation tim e were followed up.Statistical analysis all data were performed using SPSS 26.0 statistical software.Chi-square and Fisher test were used for categorical data,independent samples t test and paired design t test were used for measurement data,and rank sum test was used for rank data.P<0.05 was considered statistically significant.Results:There was no statistically significant difference in age,sex ratio,and preoperative tear trough depression grading between the analysis of the observation group and the control group,P>0.05;the total effective rate of clinical efficacy in the observation group(100%)was greater than that in the control group(80%),the tear trough depression grade in the observation group was better than that in the control group at 3 months after operation,the wrinkle score at 3 months after surgery in the observation group(1.40±0.56)was lower than that of the control group(2.07±0.74),the preoperative tarsal orbicularis oculi muscle condition score in the observation group(1.93±0.83)was higher than that at 3 months postoperatively(1.47±0.63),the incidence of postoperative complications in the observation group(26.67%)was lower than that in the control group(56.67%),and the incidence of postoperative lower eyelid swelling in the observation group(26.67%)was higher than that in the control group(6.67%).),the operation time in the observation group(135.83±25.61min)was longer than that in the control group(58.17±10.65min),and the recovery time of the lower eyelid in the observation group(22.33±5.99d)was longer than that in the control group(12.67±4.05d).The 3-month patient satisfaction score(18.93±2.13)and the 6-month postoperative patient satisfaction score(23.87±1.14)were higher than those of the control group(15.73±4.62,19.03±2.43),and the above differences were statistically significant,P< 0.05;The observation group was compared with the control group in terms of tarsal orbicularis oculi score at3 months after operation(1.47±0.63 vs 1.80±0.66),postoperative lower eyelid depression(0%vs16.67%),lower eyelid ectropion(0% vs 16.67%),epiphora(13.33%vs 16.67%),incision infection(3.33% vs 3.33%),obvious scar(0% vs 10%),etc.There was no statistical significance in the above differences,P>0.05.Conclusion:(1)Both surgical approaches have clinical efficacy in the treatment of lower eyelid bags in the middle-aged and elderly.(2)The operation time and the recovery time of the lower eyelid appearance were shorter with the classic external approach lower blepharoplasty,and the complication rate was higher.(3)Lower blepharoplasty combined with orbital septal fat release has a high overall clinical efficiency,low complication rate,better improvement of tear trough depressions and lower lid wrinkles,and higher long-term follow-up patient satisfaction,which is worthy of clinical application and development.