الفهرس 
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Abstract
bital septum plication provides various benefits, including eliminating the necessity for a septal incision and the ability to relocate infraorbital fat in a more anatomically suitable manner.
This study aimed to compare the results of traditional lower blepharoplasty with fat excision and orbital septal plication method using orbital grey scale analysis (OGS) as a new objective method for assessment.
We conducted a prospective cohort study on patients with bilateral baggy lower eyelids who underwent traditional lower blepharoplasty with fat excision or fat-sparing technique using orbital septal plication.
The study was performed on 40 patients (20 patients per group). The right medial OGS showed a significant reduction in both fat-sparing and traditional groups (p < 0.001, each). However, the percentage of reduction was higher in the fat-sparing group than in the traditional group (35.8 ± 2.8 in fat-sparing versus 14.6 ± 3.4 in traditional groups; p < 0.001). Similarly, the left medial OGS showed a notable decrease in both groups (p < 0.001, each). The percentage of reduction was also higher in the fat-sparing group (35.9 ± 2.9 in the fat-sparing group versus 14.7 ± 3.3 in the traditional group; p < 0.001).
O
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Regarding the central OGS, the left and right sides demonstrated a considerable reduction in the fat-sparing and traditional groups (p < 0.001, each). The percentage of reduction was again higher in the fat-sparing group (p <0.001, each).
While regarding the lateral OGS, the right and left OGS showed a considerable reduction in the fat-sparing and traditional groups (p < 0.001, each). For the right lateral OGS, the percentage of reduction was higher in the fat-sparing group (32.6 ± 2.4 fat-sparing versus 17.8 ± 1.6 in the traditional groups; p < 0.001). Likewise, the left lateral OGS showed a decrease in the fat-sparing and traditional groups (p < 0.001, each) with a higher percentage of reduction in the fat-sparing group (33.1 ± 2.1 fat-sparing versus 17.8 ± 1.5 in the traditional groups; p < 0.001).
Overall, the total orbital grey scale (OGS) score showed a significant reduction postoperatively. Particularly, the fat-sparing group showed a higher reduction percentage than the traditional groups post-operatively (34.6 ± 2.9 in fat-sparing versus 15.5 ± 3.3 in traditional groups; p < 0.001), as shown in
The application of the fat sparing technique is associated with favorable cosmetic outcomes and a lower complication rate than the traditional technique with fat excision. Further studies with a longer duration of follow-up and larger sample size are
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required to estimate the risk of recurrence and the need for a revision procedure.