Guiding Needle-Assisted Redistribution of Orbital Fat in Transconjunctival Lower Eyelid Blepharoplasty.

Accurate fat redistribution after lacrimal trough ligament release by the conjunctival approach is difficult due to the limited surgical field of view. Therefore, creative methods are urgently needed. To explore an innovative technique focused on fat redistribution using a guiding needle in transconjunctival lower eyelid blepharoplasty to correct tear trough deformity. Twenty-six patients underwent transconjunctival lower eyelid blepharoplasty. The retroseptal fat was dissected and laid out using a guiding needle for redistribution over the orbital rim. Closing sutures were knotted internally to the periosteum. Patients were followed for 6 months. All patients diagnosed with predominant orbital fat bulge and tear trough deformity without noticeable lower eyelid skin laxity presented impressive correction of the eyelid bags and tear trough deformities at 6 months follow-up. The average score for postoperative effect was 5.692 ± 0.618 on a scale of 1-6 (1 being poor and 6 being good). This guiding needle is a simple and effective tool for correcting eyelid bags and tear trough deformities by redistributing orbital fat in the transconjunctival lower eyelid blepharoplasty.