title: Treatment of Tear Trough Deformity: Fat Repositioning versus Autologous Fat Grafting.
abstract: BACKGROUND
  Fat-preserving lower blepharoplasty techniques and filling techniques using autologous or non-autologous materials are increasingly used to treat tear trough deformity. However, there has been no definitive comparison of the results of fat repositioning versus autologous fat grafting for this condition. The authors used statistical analysis to compare the results of the two methods.
  
  
  METHODS
  From October 2013 to September 2015, a total of 101 patients, aged 20-43 years, underwent fat repositioning or autologous fat grafting in our department. Group 1 (51 patients, 102 eyes) underwent intraorbital fat repositioning with septal reset by transconjunctival lower blepharoplasty. Group 2 (50 patients, 100 eyes) underwent autologous fat grafting by lipoinjection.
  
  
  RESULTS
  No significant complications occurred in any patient postoperatively. Four of 102 eyes in Group 1 and seven of 100 eyes in Group 2 had no improvement; the rest had different degrees of improvement. In Grade II and III deformities, fat repositioning resulted in significantly greater improvement of grade compared with autologous fat grafting. The surgical method of Group 1 resulted in better curative effects than that of Group 2.
  
  
  CONCLUSIONS
  In patients with tear trough deformity and without obvious skin or orbicularis oculi muscle laxity, both fat repositioning and autologous fat grafting are acceptable for mild deformity. In patients with higher-grade deformities, fat repositioning produced superior results than autologous fat grafting.
  
  
  METHODS
  This journal requires that the 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 http://www.springer.com/00266 .
authors.affiliation: Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, ZheJiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, People's Republic of China.
authors.forename: Chiao-Yun
authors.initials: CY
authors.lastname: Chiu
authors.affiliation: Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, ZheJiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, People's Republic of China.
authors.forename: Yi-Chen
authors.initials: YC
authors.lastname: Shen
authors.affiliation: Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, ZheJiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, People's Republic of China.
authors.forename: Qing-Fang
authors.initials: QF
authors.lastname: Zhao
authors.affiliation: Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, ZheJiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, People's Republic of China.
authors.forename: Fu-Liang
authors.initials: FL
authors.lastname: Hong
authors.affiliation: Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, ZheJiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, People's Republic of China. xujinghong68@163.com.
authors.forename: Jing-Hong
authors.initials: JH
authors.lastname: Xu
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D019882:Blepharoplasty / Q000379:methods*; D015331:Cohort Studies; D004954:Esthetics; D005143:Eyelids / Q000002:abnormalities* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D013536:Suture Techniques; D013624:Taiwan; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Autologous fat grafting; Fat reposition; Lower blepharoplasty; Tear trough; Transconjunctival route