{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T10:00:07Z","timestamp":1783764007694,"version":"3.55.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T00:00:00Z","timestamp":1729123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Enophthalmia (abnormally sunken eyeball in the socket) and ptotic upper lid, as well as lower lid symptoms, are commonly observed in patients seeking periorbital rejuvenation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The aim of this study was to assess the effect of transconjunctival lower blepharoplasty (TCLB) modified by adding deframing and decompression maneuvers to the lower orbital fat compartment (LOFC) and its support structures to obtain better results in both the lower and upper lids.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Modified TCLB was performed in patients with lower eyelid symptoms. Palpebral fissure height (PFH) (the distance between the upper and lower eyelids in vertical alignment with the center of the pupil) was measured before surgery and 12 months postoperatively from 3-dimensional photographs. These data were compared to validate the postoperative eye-opening effect. The weight of the excised fat from each LOFC was also measured and compared.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty patients (36 females and 4 males) who underwent modified TCLB were followed up 12 months postoperatively. Mean [standard deviation] preoperative PFHs were 8.41 [1.15] mm (range, 6.1-10.7 mm) for the right and 8.41 [1.12] mm (range, 5.5-10.4 mm) for the left. Postoperative PFHs were 9.26 [0.95] mm (range, 6.4-11.1 mm) for the right and 9.21 [0.94] mm (range, 6.2-11.1 mm) for the left. The improvement in postoperative eye opening was statistically significant. The total excised LOFC was 0.43 [0.24] g (range, 0-1.2 g) for the right and 0.42 [0.25] g (range, 0-1.5 g) for the left. The largest amount of fat was excised bilaterally from the lateral LOFC, and the difference was statistically significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The results after the modified TCLB clearly demonstrate increased eye-opening ability and marked resolution of observable symptoms. The anatomical dynamics of the orbit involved in this procedure are detailed through scientific data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence: 4 (Therapeutic)<\/jats:title>\n                  <jats:p\/>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjae205","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T10:13:50Z","timestamp":1729160030000},"page":"126-135","source":"Crossref","is-referenced-by-count":5,"title":["Eye-Opening Effect Achieved by Modified Transconjunctival Lower Blepharoplasty"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2328-3619","authenticated-orcid":false,"given":"Takayuki","family":"Kubo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,17]]},"reference":[{"key":"2025011613021417000_sjae205-B1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1093\/asj\/sjy034","article-title":"Blepharoplasty: anatomy, planning, techniques, and safety","volume":"39","author":"Alghoul","year":"2019","journal-title":"Aesthet Surg J"},{"key":"2025011613021417000_sjae205-B2","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1177\/1090820X12442372","article-title":"Codner tear trough deformity: review of anatomy and treatment options","volume":"32","author":"Stutman","year":"2012","journal-title":"Aethet Surg J"},{"key":"2025011613021417000_sjae205-B3","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.1097\/PRS.0b013e31824ecd77","article-title":"The tear trough ligament: anatomical basis for the tear trough deformity","volume":"129","author":"Wong","year":"2012","journal-title":"Plast Reconstr Surg"},{"key":"2025011613021417000_sjae205-B4","doi-asserted-by":"publisher","first-page":"65","DOI":"10.4103\/0974-2077.184046","article-title":"Infraorbital dark circles: a review of the pathogenesis, evaluation and treatment","volume":"9","author":"Vrcek","year":"2016","journal-title":"J Cutan Aesthet Surg"},{"key":"2025011613021417000_sjae205-B5","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.fsc.2016.01.002","article-title":"Upper lid blepharoplasty","volume":"24","author":"Samuel","year":"2016","journal-title":"Facial Plast Surg Clin North Am"},{"key":"2025011613021417000_sjae205-B6","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.fsc.2015.12.004","article-title":"Lower eyelid blepharoplasty","volume":"24","author":"Branham","year":"2016","journal-title":"Facial Plast Surg Clin North Am"},{"key":"2025011613021417000_sjae205-B7","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.cxom.2016.05.011","article-title":"Transconjunctival lower blepharoplasty","volume":"24","author":"Pack","year":"2016","journal-title":"Atlas Oral Maxillofac Surg Clin North Am"},{"key":"2025011613021417000_sjae205-B8","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/s00266-022-03183-0","article-title":"Surgical correction of tear trough deformity (TTD) with orbicularis retaining ligament release and volume augmentation for periorbital rejuvenation: review of the literature","volume":"47","author":"Atiyeh","year":"2023","journal-title":"Aesthetic Plast Surg"},{"key":"2025011613021417000_sjae205-B9","doi-asserted-by":"publisher","first-page":"2911","DOI":"10.1111\/jocd.13978","article-title":"Transconjunctival lower eyelid blepharoplasty with fat transposition above the orbicularis muscle for improvement of the tear trough deformity","volume":"20","author":"Majidian Ba","year":"2021","journal-title":"J Cosmet Dermatol"},{"key":"2025011613021417000_sjae205-B10","doi-asserted-by":"publisher","first-page":"e2217","DOI":"10.1097\/GOX.0000000000002217","article-title":"Periorbital aesthetic surgery: a simple algorithm for the optimal youthful appearance","volume":"7","author":"Ak\u015fam","year":"2019","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2025011613021417000_sjae205-B11","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/s0161-6420(89)32787-4","article-title":"Transconjunctival lower eyelid blepharoplasty. Technique and complications","volume":"96","author":"Baylis","year":"1989","journal-title":"Ophthalmology"},{"key":"2025011613021417000_sjae205-B12","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1055\/s-0029-1224797","article-title":"Keloids: pathogenesis, clinical features, and management","volume":"23","author":"Chike-Obi","year":"2009","journal-title":"Semin Plast Surg"},{"key":"2025011613021417000_sjae205-B13","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/978-3-030-44766-3_4","volume-title":"Textbook on Scar Management: State of the Art Management and Emerging Technologies [Internet]","author":"Huang","year":"2020"},{"key":"2025011613021417000_sjae205-B14","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1097\/00006534-199711000-00026","article-title":"Anatomy, pathophysiology, and prevention of senile enophthalmia and associated herniated lower eyelid fat pads","volume":"100","author":"Camirand","year":"1997","journal-title":"Plast Reconstr Surg"},{"key":"2025011613021417000_sjae205-B15","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1076\/orbi.22.4.239.17245","article-title":"Hertel exophthalmometry: reliability and interobserver variation","volume":"22","author":"Kashkouli","year":"2003","journal-title":"Orbit"},{"key":"2025011613021417000_sjae205-B16","first-page":"662","article-title":"Exophthalmometry measurements in Asians","volume":"44","author":"Erb","year":"2003","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025011613021417000_sjae205-B17","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1097\/00006534-200209010-00025","article-title":"Surgical anatomy of the ligamentous attachments of the lower lid and lateral canthus","volume":"110","author":"Muzaffar","year":"2002","journal-title":"Plast Reconstr Surg"},{"key":"2025011613021417000_sjae205-B18","doi-asserted-by":"publisher","first-page":"39","DOI":"10.3109\/08820538.2010.496695","article-title":"Blepharoptosis","volume":"25","author":"de Figueiredo","year":"2010","journal-title":"Semin Ophthalmol"},{"key":"2025011613021417000_sjae205-B19","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s00266-003-0127-5","article-title":"Ptosis: causes, presentation, and management","volume":"27","author":"Finsterer","year":"2003","journal-title":"Aesthetic Plast Surg"},{"key":"2025011613021417000_sjae205-B20","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1097\/01.icu.0000186647.00413.21","article-title":"Advances in the diagnosis and treatment of ptosis","volume":"16","author":"Baroody","year":"2005","journal-title":"Curr Opin Ophthalmol"},{"key":"2025011613021417000_sjae205-B21","doi-asserted-by":"publisher","first-page":"2468","DOI":"10.1038\/s41433-021-01547-5","article-title":"A review of acquired blepharoptosis: prevalence, diagnosis, and current treatment options","volume":"35","author":"Bacharach","year":"2021","journal-title":"Eye (Lond)"},{"key":"2025011613021417000_sjae205-B22","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.pcl.2014.03.006","article-title":"Amblyopia","volume":"61","author":"DeSantis","year":"2014","journal-title":"Pediatr Clin North Am"},{"key":"2025011613021417000_sjae205-B23","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1097\/00004397-199703730-00010","article-title":"The aponeurotic approach for the correction of blepharoptosis","volume":"37","author":"Shovlin","year":"1997","journal-title":"Int Ophthalmol Clin"},{"key":"2025011613021417000_sjae205-B24","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.jcjo.2011.06.010","article-title":"Not only hard contact lens wear but also soft contact lens wear may be associated with blepharoptosis","volume":"46","author":"Bleyen","year":"2011","journal-title":"Can J Ophthalmol"},{"key":"2025011613021417000_sjae205-B25","first-page":"391","article-title":"Lower eyelid blepharoplasty: a procedure in evolution","volume":"107","author":"Holds","year":"2010","journal-title":"Mo Med"},{"key":"2025011613021417000_sjae205-B26","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1093\/asj\/sjad245","article-title":"An overview of surgical approaches for lower eyelid blepharoplasty","volume":"43","author":"Nahai","year":"2023","journal-title":"Aesthet Surg J"},{"key":"2025011613021417000_sjae205-B27","doi-asserted-by":"publisher","first-page":"59","DOI":"10.3109\/08820538.2010.488570","article-title":"Ectropion","volume":"25","author":"Bedran","year":"2010","journal-title":"Semin Ophthalmol"},{"key":"2025011613021417000_sjae205-B28","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1097\/00006534-199508000-00014","article-title":"Arcus marginalis release and orbital fat preservation in midface rejuvenation","volume":"96","author":"Hamra","year":"1995","journal-title":"Plast Reconstr Surg"},{"key":"2025011613021417000_sjae205-B29","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1097\/00006534-200002000-00044","article-title":"Transconjunctival orbital fat repositioning: transposition of orbital fat pedicles into a subperiosteal pocket","volume":"105","author":"Goldberg","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"2025011613021417000_sjae205-B30","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1097\/01.PRS.0000091238.72843.7E","article-title":"The tear \u201cTROUF\u201d procedure: transconjunctival repositioning of orbital unipedicled fat","volume":"112","author":"Kawamoto","year":"2003","journal-title":"Plast Reconstr Surg"},{"key":"2025011613021417000_sjae205-B31","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.asj.2008.02.002","article-title":"Transconjunctival orbital fat repositioning for tear trough deformity in young asians","volume":"28","author":"Momosawa","year":"2008","journal-title":"Aesthet Surg J"},{"key":"2025011613021417000_sjae205-B32","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1097\/00002341-198703020-00003","article-title":"Autogenous fat grafting by injection","volume":"3","author":"Silkiss","year":"1987","journal-title":"Opthal Plast Reconstr Surg"},{"key":"2025011613021417000_sjae205-B33","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1097\/PRS.0000000000003356","article-title":"Micro free orbital fat grafts to the tear trough deformity during lower blepharoplasty","volume":"139","author":"Miranda","year":"2017","journal-title":"Plast Reconstr Surg"},{"key":"2025011613021417000_sjae205-B34","doi-asserted-by":"publisher","first-page":"1716","DOI":"10.1097\/00006534-199810000-00063","article-title":"Lower eyelid volume augmentation with fat pearl grafting","volume":"102","author":"Choo","year":"1998","journal-title":"Plast Reconstr Surg"},{"key":"2025011613021417000_sjae205-B35","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1093\/asj\/sjad232","article-title":"Mince free fat graft pedicle fat flap efface orbital rim hollow in lower blepharoplasty","volume":"44","author":"Karimi","year":"2023","journal-title":"Aesthet Surg J"},{"key":"2025011613021417000_sjae205-B36","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1007\/s00266-006-0190-9","article-title":"Lower lid deformity secondary to autologous fat transfer: a cautionary tale","volume":"32","author":"Spector","year":"2008","journal-title":"Aesthetic Plast Surg"},{"key":"2025011613021417000_sjae205-B37","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/0002-9394(89)90823-4","article-title":"Sudden unilateral visual loss after autologous fat injection into the glabellar area","volume":"107","author":"Dreizen","year":"1989","journal-title":"Am J Ophthalmol"},{"key":"2025011613021417000_sjae205-B38","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/s004150050177","article-title":"Middle cerebral artery occlusion AND ocular fat embolism after autologous fat injection in the face","volume":"245","author":"Feinendegen","year":"1998","journal-title":"J Neurol"},{"key":"2025011613021417000_sjae205-B39","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/S0094-1298(20)31220-7","article-title":"Treatment of exophthalmos by orbital fat removal","volume":"20","author":"Stark","year":"1993","journal-title":"Clin Plast Surg"},{"key":"2025011613021417000_sjae205-B40","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1097\/SAP.0b013e31818c4b22","article-title":"Lower eyelid anatomy: an update","volume":"63","author":"Kakizaki","year":"2009","journal-title":"Ann Plast Surg"}],"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjae205\/60482072\/sjae205.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/45\/2\/126\/60482072\/sjae205.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/45\/2\/126\/60482072\/sjae205.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T13:04:19Z","timestamp":1737032659000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/article\/45\/2\/126\/7824546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,17]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,10,17]]},"published-print":{"date-parts":[[2025,1,16]]}},"URL":"https:\/\/doi.org\/10.1093\/asj\/sjae205","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2024,10,17]]}}}