The lecture title was as follows.
Roughly translated: transconjunctival lower blepharoplasty — i.e., the fat-repositioning approach.
Historically, many surgeons simply removed the fat, and some still do.
Tear-trough deformity refers to the depression along the lower lid where a small ligament tethers the soft tissue down.
Because that ligament holds the tissue in place, the fat above it sits draped over and creates the visible bulge.
From the lecture: in the slide photo, you can see the ligament tethering the tissue right where the fat appears to bulge. See the arrow.
The technique flattens the fat and repositions it across the trough, like this.
Once that is done, the bulge in the upper diagram disappears.
And this is the final result.
There is a key point to the operation.
There is a specific technique to keep the bulge from recurring. I shared that tip with the audience.
I also shared the techniques I use to reduce pain and complications.
I hope every surgeon in the room will be able to perform this safely and confidently.