Volumetric rejuvenation of the tear trough with repo and Ristow.
OBJECTIVE
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.
*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.
Adi
A
Einan-Lifshitz
John B
JB
Holds
Allan E
AE
Wulc
Morris E
ME
Hartstein
D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000379:methods*; D005124:Eye Abnormalities / Q000601:surgery*; D005141:Eyelid Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007765:Lacrimal Apparatus / Q000002:abnormalities*; D008297:Male; D008875:Middle Aged