Sustained Aesthetic Improvement in Midface Micro-Autologous Fat Transplantation Auxiliary Support on Lower Eyelid Rejuvenation: A Comprehensive Evaluation.

Purpose: To evaluate the deformities of tear troughs, and contours of the infraorbital-midfacial region, and to observe the clinical therapeutic effects of lower eyelid reconstruction combined with micro-autologous fat transplantation in orbital-midfacial rejuvenation.

Methods: A total of 87 individuals seeking cosmetic improvement, aged 25 to 45 years (mean age 36.7 years), were selected for this study from March 2020 to March 2022. The patients presented with eye bags combined with tear troughs, with or without accompanying skin laxity, and exhibited varying degrees of midfacial flattening or concavity. After a thorough preoperative assessment, eligible candidates underwent lower eyelid reconstruction combined with midfacial micro-autologous fat transfer, while skin excision was performed for those with skin laxity. The effectiveness of the surgery was comprehensively evaluated using the tear trough rating scale (TTRS), the midface volume scale (MMVS), and the Patients' Aesthetic Improvement Scale. Additionally, a 3D scanner and postoperative complications were considered in the evaluation process.

Results: Follow-up at a average 24.3 months showed sustained good results and high patient satisfaction. The TTRS score showed a significant decrease post-treatment and continued to be low even 18 months post-operation. The MMVS responder rate remained high, staying above 70% at the 18 months after the surgery. Additionally, the PAIS score demonstrated that all patients experienced significant improvement. 3D Scanner showed also volumetric changes in surgical area. There were no apparent complications among the patients, and all of them achieved satisfactory results.

Conclusion: Treating aging manifestations in the orbital-midfacial region as a whole, alongside lower eyelid reconstruction, and correcting volume changes through fat grafting can achieve comprehensive aesthetic effects in orbital-midfacial rejuvenation.

Level Of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266 .