en Plastic Surgery Plastic Surgery Original Research: Clinical Science Original Research: Clinical Science <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">The anatomy of the eyelid changes with age. Multiple changes were observed in the eyelids and the surrounding structures including the malar region. Aging affects the appearance of eyelids and midface by the formation of tear trough deformity and malar flattening and ptosis. To define the effect of malar fat suspension on the lateral part of the infraorbital wall and orbital fat transposition in tear-trough and malar flattening and ptosis.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> A retrospective study was carried out on 15 patients who had surgeries between January 2020 and January 2022. This technique combines orbital fat transposition to the medial side of the infraorbital wall and malar fat suspension to the lateral side of the infraorbital wall. The average follow-up period was 12 months. Values were compared by paired samples student or Wilcoxon signed rank test for quantitative and qualitative data respectively. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results:</b> There was a significant improvement in tear trough deformity, malar ptosis, and midface lift (</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> < 0.5). No recurrence was observed on follow-up of 12 months. One patient experienced minor postoperative complications in the form of prolonged ecchymosis for 2 months.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; Conclusion:</span></span></b><span style="font-size:9.0pt"><span style="font-style:normal"> The transcutaneous lower blepharoplasty with orbital fat transposition and malar fat suspension to the lateral part of the infraorbital wall can be considered a safe and effective intervention with improved aesthetic outcome. Thus, it is recommended in patients with tear trough deformity and malar ptosis.</span></span></span></span></span></span></span></span><br> &nbsp; Blepharoplasty, Malar ptosis, Midface lift, Lower eyelid 616 622 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-8663-1&slc_lang=en&sid=1 Mahmoud Abdelhamid Elhendawy Dr.ma7moudelhendawy@yahoo.com 200319475328460089451 0009-0001-0594-6597 No Department of Plastic Surgery, Faculty of Medicine, Al-Azhar University, Assiut, Egypt Ahmed M Omran Omranplasticsurgeon@gmail.com 200319475328460089452 0009-0002-2708-1165 Yes Department of Plastic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Sherif Hamdeno Sherif.youssif83@azhar.edu.eg 200319475328460089453 200319475328460089453 No Department of Plastic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Hazem Dahshan Zoma3117@azhar.edu.eg 200319475328460089454 200319475328460089454 No Department of Plastic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Ahmed Abu_Elsoud ahmedabuelsoud79@gmail.com 200319475328460089455 0009-0004-0926-9046 No Department of Plastic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Ahmed Salem ahmedsalemplastic@gmail.com 200319475328460089456 0009-0008-7514-4718 No Department of Plastic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Mohamed Ali Abdelaziz dr.muhamedaly@gmail.com 200319475328460089457 200319475328460089457 No Department of Plastic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Khallad Sholkamy Dr_khallad@azhar.edu.eg 200319475328460089458 200319475328460089458 No Department of Plastic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Saber M. Abdelmaksoud Saber.hamza@yahoo.com 200319475328460089459 0009-0003-1149-8801 No Department of Plastic Surgery, Faculty of Medicine, Port Said University, Port Said, Egypt