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The Effect of Transconjunctival Blepharoplasty on Margin Reflex Distance 2

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Abstract

Background

The objective of this study was to determine the effects of lower eyelid transconjunctival blepharoplasty (TCB) on lower eyelid position.

Methods

Transconjunctival blepharoplasty was performed alone in 15 lower eyelids without simultaneous canthoplasty or upper eyelid procedure. In this study, blepharoplasty was performed by the transconjunctival approach without removal of skin. Four eyes received TCB plus Erbium laser, two patients received TCB plus trichloroacetic acid peel (TCA), and three patients received TCB plus fat transposition. Pre-operative and post-operative margin reflex distance 1 (MRD 1) and margin reflex distance 2 (MRD 2) were compared, with MRD 1 acting as the control.

Results

Average time to post-operative photo was 4.6 months (1–10 months). The changes in MRD 2 and MRD 1 were compared pre- and post-operatively, and the difference reached significance by one-tailed comparison (P < 0.05). In 11/15 eyes (73 %), MRD 2 decreased post-operatively. In 6/7 eyes (86 %), lower lid scleral show was eliminated post-operatively. There were no cases of lid retraction noted.

Conclusions

Transconjunctival blepharoplasty (± skin resurfacing) did not induce lid retraction but elevated the lower lid in majority of patients. Elevation of the lower lid can reduce or eliminate scleral show inferiorly, providing further cosmetic advantage. The presumed mechanism of lower lid height elevation is partial recession of the lower lid retractors during the surgical approach to the fat pockets.

Level of Evidence IV

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Acknowledgments

This research was supported by an unrestricted grant from the Research to Prevent Blindness.

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Authors and Affiliations

  1. Department of Ophthalmology, NewYork-Presbyterian/Weill Cornell Medical Center, 11th and 12th Floors, New York, NY, 10021, USA

    Kira L. Segal, Ben Levine & Gary J. Lelli Jr.

  2. Department of Ophthalmology, NYU Langone Medical Center, Institute of Reconstructive Plastic Surgery, 240 East 38th Street, 13th Floor, New York, NY, 10016, USA

    Payal Patel

  3. Department of Ophthalmology, NYU Langone Medical Center, Institute of Reconstructive Plastic Surgery, 635 Park Avenue, New York, NY, 10021, USA

    Richard D. Lisman

Authors
  1. Kira L. Segal
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  2. Payal Patel
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  3. Ben Levine
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  4. Richard D. Lisman
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  5. Gary J. Lelli Jr.
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Correspondence to Gary J. Lelli Jr..

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Segal, K.L., Patel, P., Levine, B. et al. The Effect of Transconjunctival Blepharoplasty on Margin Reflex Distance 2. Aesth Plast Surg 40, 13–18 (2016). https://doi.org/10.1007/s00266-015-0583-8

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  • DOI: https://doi.org/10.1007/s00266-015-0583-8

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