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Volumetric Rejuvenation of the Tear Trough With Repo and Ristow

Einan-Lifshitz, Adi M.D.*; Holds, John B. M.D.; Wulc, Allan E. M.D.; Hartstein, Morris E. M.D.*

Ophthalmic Plastic and Reconstructive Surgery: November/December 2013 - Volume 29 - Issue 6 - p 481–485
doi: 10.1097/IOP.0b013e3182a23270
Original Investigations

Purpose: The authors report the results of their approach for the treatment of the tear trough deformity, by lower eyelid blepharoplasty with fat repositioning and fat transfer to Ristow’s space and the deep medial fat compartment.

Methods: One hundred fourteen eyes of 57 patients underwent lower eyelid blepharoplasty, fat repositioning, and fat transfer between 2010 and 2012.

Results: No major complications were observed in any of the patients in this series. In all cases, there was significant improvement in the lower eyelid contour, tear trough, and blending of the transition at the eyelid–cheek junction noted by both patients and physicians.

Conclusions: Despite the availability of multiple procedures, effacement of the tear trough region remains a challenge. The addition of fat transfer to Ristow’s space and the deep medial fat compartment to traditional fat repositioning lower blepharoplasty are effective methods for volumizing the tear trough and may synergistically improve outcomes.

Treatment of the tear trough deformity, by lower eyelid blepharoplasty with fat repositioning and fat transfer to Ristow’s space and the deep medial fat pad showed significant improvement in the lower eyelid contour, tear trough, and blending of the transition at the eyelid–cheek junction.

*Department of Ophthalmology, Assaf Harofeh Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Ophthalmology and Otolaryngology, Saint Louis University, Saint Louis, Missouri; and Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, Departments of Ophthalmology and Otolaryngology, Drexel University, Philadelphia, Pennsylvania, U.S.A.

Accepted for publication June 18, 2013.

The authors have no financial or conflicts of interest to disclose.

Presented at the annual American Society of Ophthalmic Plastic and Reconstructive Surgery Symposium, Chicago, 2012.

Address correspondence and reprint requests to Adi Einan-Lifshitz, M.D., Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin 70300, Israel. E-mail: adi.einan@gmail.com

© 2013 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.