Innovative Syringe-Guided Barbed Sutures for Orbital Fat Repositioning: A Retrospective Study.

Objective: To investigate the clinical efficacy of a method that corrects tear trough deformity by subcutaneous fixation of orbital septal fat flaps using syringe-guided absorbable barbed sutures.

Methods: A retrospective analysis was conducted on the clinical data of 125 cases with lower eyelid bags accompanied by tear trough deformity who were treated in the Department of Plastic Surgery at Zhengzhou People's Hospital from 2020 to 2024. Among them, there were 13 males and 112 females, with an average age of 34.2 ± 6.8 years. A 1 to 1.5 cm horizontal transconjunctival incision was made to release the orbital septal fat, forming a pedicled fat flap. The premaxillary space and part of the prezygomatic space were dissected. A syringe needle was bent and vertically inserted through the deepest point of the tear trough depression into the dissected space. One to 2 absorbable barbed sutures were passed through the central part of the fat flap. The tail end of the suture was inserted into the bent needle. The needle was retracted subcutaneously (the needle remained subcutaneous throughout), exited through another tunnel, and then a knot was tied to fix the fat flap at a position satisfactory to both the surgeon and the patient. The Tear Trough Rating Scale scores were assessed preoperatively and at 6 months postoperatively.

Results: The Tear Trough Rating Scale scores at 6 months postoperatively were significantly lower than those preoperatively (P < 0.05), indicating a marked improvement in tear trough deformity. No complications, such as lower eyelid retraction, ectropion, or hematoma, occurred in any patient.

Conclusion: The method of subcutaneous fixation of orbital septal fat flaps using syringe-guided barbed sutures effectively improves tear trough deformity and midfacial depression.