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Lower eyelid transconjunctival blepharoplasty with fat repositioning: outcomes and complications

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

The lower eyelid changes with aging include atrophy of the orbital septum with subsequent forward herniation of orbital fat, descent of the sub-orbicularis oculi muscle fat, ptosis of the orbicularis oculi muscle, weakening of the orbito-malar ligament and the development of laxity of the eyelid skin, the tarsus and the canthal tendons. In this article we aim at describing our experience of using a modified lower lid blepharoplasty with fat repositioning in patients with lower lid fat prolapse and tear trough deformity.

Methods

A retrospective, non-randomised non-comparative interventional consecutive case series of patients seeking surgical treatment. Patients underwent surgery between April 2010 and October 2019 by a single surgeon (BL). Patient demographics, clinical examination, preoperative and postoperative clinical photography, outcomes and complications were recorded. Follow-up was initially at 2 weeks and finally at 16–20 weeks. Outcomes were recorded as subjective improvement and degree of patient satisfaction.

Results

A total of 150 patients were recruited in the study period. The mean age at the time of surgery was 49. One hundred forty-one (94%) patients were very satisfied with the final outcome of their surgery, 5 were satisfied and 4 were dissatisfied. One patient developed a bilateral lower lid infection requiring abscess drainage. Seventeen other patients experienced minor complications in the postoperative period, including 2 with a unilateral lower lid infection requiring oral antibiotics, 3 with a temporary inferior oblique palsy, 1 with temporary unilateral infraorbital nerve dysfunction, 3 with residual prolapses of the lateral fat pads, 1 with a medial lower lid lump, 2 with a conjunctival granuloma, 2 with a temporary medial ectropion, 1 with persistent unilateral lower lid oedema, 1 with persistent bilateral lower lid oedema and 1 with unilateral lower lid retraction.

Conclusions

We report a high patient satisfaction with a low rate of significant complications following our modified lower lid transconjunctival blepharoplasty with fat repositioning.

Level of evidence: Level III, therapeutic study

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Authors and Affiliations

  1. Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK

    Paul S. Cannon

  2. The Face & Eye Clinic, 2 Gibwood Road, Manchester, M22 4BT, UK

    Brian Leatherbarrow

Authors
  1. Paul S. Cannon
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  2. Brian Leatherbarrow
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Correspondence to Paul S. Cannon.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This retrospective study of case series did not require ethical approval from the Institutional Review Board, although it did adhere to the tenets of the 1964 Declaration of Helsinki.

Informed consent

Written informed consent was obtained from all patients for the use of clinical images and from Thieme Publications for images used.

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Cannon, P.S., Leatherbarrow, B. Lower eyelid transconjunctival blepharoplasty with fat repositioning: outcomes and complications. Eur J Plast Surg 43, 719–726 (2020). https://doi.org/10.1007/s00238-020-01671-7

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  • DOI: https://doi.org/10.1007/s00238-020-01671-7

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