Three-dimensional orbital septal fat flap fabrication during eyelid bags surgery

LI Huixian; LEI Shaorong; FAN Pengju; XIAO Yutian

doi:10.3969/j.issn.1673-7040.2025.09.004

Abstract：Objective To investigate the efficacy of three-dimensional orbital septal fat flap transposition in the correction of tear trough deformity associated with lower eyelid bags.Methods A retrospective analysis was conducted of 167 patients(334 eyes)with lower eyelid bulging combined with varying degrees of tear trough deformity,who underwent treatment in the Department of Plastic and Aesthetic Surgery,Xiangya Hospital of Central South University,from January 2022 to December 2024.All patients underwent lower eyelid bag cor-rection combined with three-dimensional orbital septal fat flap transposition for tear trough filling.Postoperative follow-up was performed to observe and evaluate surgical outcomes.Results All 167 patients successfully completed the surgery.Subcutaneous nodules in the lower tear trough were palpated in 20 patients(11.98％,20/167),including 3 cases(3.33％,3/90)via transcutaneous approach and 17 cas-es(22.08％,17/77)via transconjunctival approach.All nodules resolved completely within 1 to 2 months of follow-up.No significant or-bital septal fat retraction,incision infection,diplopia,injury to the infraorbital vessels or nerves,contour irregularity,or ectropion was ob-served.Patient self-assessment showed 143 cases satisfied,19 cases basically satisfied,and 5 cases dissatisfied.The global aesthetic im-provement scale(GAIS)scores assessed by attending plastic surgeons averaged(2.71±0.50),including 123 cases scoring 3,40 cases scor-ing 2,and 4 cases scoring 1.Conclusion Three-dimensional orbital septal fat flap transposition for tear trough correction in patients with lower eyelid bags effectively reduces orbital septal fat retraction,demonstrates favorable safety,and is worthy of clinical application and promotion.