• Seungkeol Yang, Bo Ri Kim, Hyung Su Kim, Chong Won Choi, Seong-Jin Jo, and Sang Woong Youn.
• Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
• J Cosmet Dermatol. 2019 Dec 1; 18 (6): 1814-1820.

BackgroundBaggy lower eyelids (BLEs) are a common cosmetic problem that is treated using various methods. However, validated objective methods for evaluating the treatment are limited.AimsA novel BLE correction procedure, transconjunctival fat resection, and subsequent fat grafting, was assessed using the orbital gray scale (OGS), a previously suggested objective measure for BLEs.MethodsAll patients were evaluated using both the tear trough rating scale (TTRS), a surgeon-derived evaluation method, and OGS, an objective computer-derived assessment. Changes throughout the surgery and their relationship to clinical characteristics, as well as the association between the two measurements, were statistically analyzed.ResultsA total of 50 patients who underwent surgery were analyzed. No major complications other than wrinkles were observed. All patients showed improvement in both the TTRS scores and OGS values (P < 0.05). Lateral OGS was improved to a greater extent in older patients (P < 0.05). Medial OGS change was associated with improvement of tear trough depression (P < 0.05). Lateral OGS change was related to decreased infraorbital fat herniation (P < 0.05). Total OGS change was related to improvement of both tear trough depression and fat prolapse (P < 0.05).ConclusionThe total OGS change was significantly associated with improvements in tear trough depression and fat bulging. Therefore, it could be a convenient objective evaluation measure for eyelid correction procedures.© 2019 Wiley Periodicals, Inc.

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