A quantitative, objective method for evaluating the surgical outcomes of baggy eyelid correction using orbital gray scale analysis.

Background: Baggy lower eyelids (BLEs) are a common cosmetic problem that is treated using various methods. However, validated objective methods for evaluating the treatment are limited.

Aims: A 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.

Methods: All 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.

Results: A 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).

Conclusion: The 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.