Internal Fixation Method Using EZ-Tcon for Transconjunctival Fat Repositioning: Clinical Outcomes and Efficacy
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ORIGINAL ARTICLE
OCULOPLASTIC
Internal Fixation Method Using EZ-Tcon for Transconjunctival Fat Repositioning: Clinical Outcomes and Efficacy Cheol Ho Chang1 • Juyoung Bae2 • Myung Kyu Cha1 • Sa Ik Bang2 Kyeong-Tae Lee2
•
Received: 27 March 2020 / Accepted: 5 July 2020 Ó The Author(s) 2020
Abstract Background Transconjunctival fat repositioning is the gold standard for the correction of tear trough deformity. For fixation of fat pedicle, the internal fixation (IF) and externalized percutaneous suture (EPS) techniques are used, which have their own advantages and disadvantages. The present study aimed to introduce a new IF technique using a devised needle (EZ-Tcon) and to compare its outcomes with those of the conventional EPS technique. Methods Patients with primary tear trough deformity who underwent transconjunctival fat repositioning were reviewed and categorized into two cohorts according to the fixation technique: cohort 1 consisted of patients treated using the conventional EPS technique and cohort 2 consisted of those in whom the new IF technique using EZTcon was adopted. Post-operative complications and aesthetic outcomes were assessed using a four-scale grading system. Results A total of 545 patients, 211 from cohort 1 and 344 from cohort 2 were evaluated with a median follow-up of 70 days. Compared to cohort 1, cohort 2 showed significantly lower rates of long-standing conspicuous scars on lower eyelid, re-operation and overall complications. In the analysis of aesthetic outcomes, 88.9 percent of cohort 2
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00266-020-01873-1) contains supplementary material, which is available to authorized users. & Kyeong-Tae Lee [email protected] 1
The Wannabe Plastic Surgical Clinic, Seoul, Korea
2
Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea
showed grade 0 (no deformity) or I (mild deformity) postoperatively. The rate of excellent outcomes (improvements of C two grades) was significantly higher in cohort 2 than in cohort 1 (p-value \ 0.001). Conclusion Our technique using EZ-Tcon could possess advantages of the conventional IF and EPS techniques, showing lower complication rates and aesthetically satisfactory outcomes, and could be a safe and reliable method of transconjunctival fat repositioning. Level of Evidence IV 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. Keywords Tear trough deformity Transconjunctival fat repositioning Tnternal fixation Complication
Introduction Tear trough deformity represents a set of conditions showing a prominent nasojugal groove with the medial periorbital hollow that extends obliquely from the medial canthus. It can be caused by a bulge of the orbital fat through the attenu
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