Skip to main content
SpringerLink
Log in

Lower Lid Blepharoplasty: The Use of Lockwood’s Ligament for Orbicularis Oculi Suspension and Orbital Fat Preservation—A New Technique

  • ORIGINAL ARTICLE
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

A new technique of lower lid blepharoplasty is presented. The technique consists of suspending the skin–muscle flap of the lower lid on the suspensory Lockwood’s ligament in all the orbit length, with preservation of the orbital fat behind the created anatomic layer. The anatomic base of the technique is analyzed by a study of the literature, by personal observations of the changes in the anatomic elements of the orbit in a large number of operations the authors performed for patients with endocrinic exophthalmos using Olivari’s method (transpalpepral orbital decompression by removal of the orbital fat), and by fresh cadaver dissections. The technique is described in detail, and the results are presented. After 8 years of follow-up evaluation, it can be confidently said that the proposed technique can solve almost all the problems associated with lower lid laxity and can be applied for the majority of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.
Fig. 5.
Fig. 6.
Fig. 7.
Fig. 8.
Fig. 9.
Fig. 10.
Fig. 11.
Fig. 12.

Similar content being viewed by others

References

  1. Anderson LR, Jordan RD: The tarsal tuck procedure: Avoiding eyelid retraction after lower blepharoplasty. Plast Reconstr Surg 85:22,1990, followed up in Plast Reconstr Surg 104:284, 1999

    Google Scholar 

  2. Botti G: Blepharoplasty: A classification of selected techniques in the treatment and prevention of lower lid margin distortions. Aesth Plast Surg 22:341, 1998

    Article  CAS  Google Scholar 

  3. Camirand A: Palpebral bags. Plast Reconstr Surg 103:1079, 1999

    Article  CAS  PubMed  Google Scholar 

  4. Camirand A, Doucet J, Harris J: Anatomy, pathophysiology, and prevention of senile enophthalmia and associated herniated lower eyelid fat pads. Plast Reconst Surg 100:1535, 1997

    Article  CAS  PubMed  Google Scholar 

  5. Camirand A, Sensoz O: Preserving the orbital fat in lower eyelidplasty. Plast Reconstr Surg 103:737, 1999

    CAS  PubMed  Google Scholar 

  6. Claude Lassus: Benefits from lifting of the lower eyelid. Aesth Plast Surg 24:424, 2000

    Google Scholar 

  7. De La Plaza R, Arroyo MJ: A new technique for the treatment of palpebral bags. Plast Reconstr Surg 81:677, 1988

    Article  Google Scholar 

  8. De La Plaza R, De La Cruz L: A new concept in blepharoplasty. Aesth Plast Surg 20:221,1996

    Article  Google Scholar 

  9. Dortzbach KR: Ophthalmic plastic surgery. Raven Press, NewYork, NewYork, 1994

  10. Ellenbogen R: Blepharoplasties. Chapter 49, p. 558

  11. Ellis E, Zide FM: Surgical approaches to the facial skeleton. Williams and Wilkins, Media, PA, USA, 1995

    Google Scholar 

  12. Fagien S: Algorithm for canthoplasty: The lateral retinacular suspension: A simplified suture canthoplasty . Plast Reconstr Surg 103:2042, 1999

    Article  CAS  PubMed  Google Scholar 

  13. Hamra ΤS: Arcus marginalis release and orbital fat preservation in midface rejuvenation. Plast Reconstr Surg 96:354, 1995

    CAS  PubMed  Google Scholar 

  14. Hamra TS: Composite rhytidectomy. Quality Medical Publishing, Inc., St. Lewis, Missouri, 1993

  15. Klatsky AS: Blepharoplasty: Mastery of plastic and reconstructive surgery. Mimis Cohen. Little, Brown and Company, Boston, NewYork, Torondo, London

  16. Krastinova-Lοlov D.: Facial aesthetic sculpturing (FAS) and mask-lift. Jorge Psillakis, Thieme Medical Publishers, NewYork, NewYork

  17. Labandter PH: Use of the orbicularis muscle flap for complex lower lid problems: A 6-year analysis. Plast Reconstr Surg 96:346, 1995

    Article  CAS  PubMed  Google Scholar 

  18. Larrabee FW Jr, Makielski HK: Surgical anatomy of the face. Raven Press, NewYork, NewYork, 1993

  19. Loeb R: Fat pad sliding and fat grafting for leveling lid depressions. Clin Plast Surg 8:757, 1981

    CAS  PubMed  Google Scholar 

  20. Mahe E: Lower lid blepharoplasty: The transconjunctival approach: Extended indications. Aesth Plast Surg 22:1, 1998

    Article  CAS  Google Scholar 

  21. Olivari N: Endocrine ophthalmopathy: Surgical treatment. Κaden, Kadem, Heidelberg, Germany

  22. Patipa M: The evaluation and management of lower eyelid retraction following cosmetic surgery. Plast Reconstr Surg 106:438, 2000

    Article  CAS  PubMed  Google Scholar 

  23. Pessa EJ, Desvigne DL, Lambros SV, Nimerick J, Zadoo PV: Changes in ocular globe-to-orbital rim position with age: Implications for aesthetic blepharoplasty of the lower eyelids. Aesth Plast Surg 23:337, 1999

    Article  CAS  Google Scholar 

  24. Sensöz O, Unlu ER, Percin A, Baran NC, Celebioglu S, Ortak T: Septo orbitoperiostoplasty for the treatment of palpebral bags: A 10-year experience. Plast Reconstr Surg 101:1657, 1998

    Article  PubMed  Google Scholar 

  25. Spinelli MH, Riou JP: Aesthetic surgery of the lower eyelid. In: Patricia Meaghers (ed.) Focal points. vol. XIII. American Academy of Ophtalmology, San Francisco, California

  26. Tyers AG, Collin JRO: Colour atlas of ophthalmic plastic surgery. Butterworth-Heinemann, Jordon Hill, Oxford, 2001

  27. Van der Menlen LJ, Cruss SJ: Ocular plastic surgery. Mosby-Wolfe, London, England, 1996

  28. Vicente P, Samper A: A complication with the aesthetic use of Botox: Herniation of the orbital fat. Plast Reconstr Surg 107:1315, 2001

    Google Scholar 

  29. Widgerow DA: Lateral internal suspension suture: Bliss technique. Aesth Plast Surg 22:130, 1998

    Article  CAS  Google Scholar 

  30. Zide MB, Jelks WG: Surgical anatomy of the orbit. Raven Press, NewYork, NewYork, 1985

Download references

Author information

Authors and Affiliations

  1. Department of Plastic Surgery, Morphoplastic Center, Voulgari 50, 54249, Thessaloniki, Greece

    Michael Stampos M.D.

Authors
  1. Michael Stampos M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael Stampos M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stampos, M. Lower Lid Blepharoplasty: The Use of Lockwood’s Ligament for Orbicularis Oculi Suspension and Orbital Fat Preservation—A New Technique. Aesth Plast Surg 31, 680–687 (2007). https://doi.org/10.1007/s00266-006-0181-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-006-0181-x

Keywords

Search

Navigation