Advertisement

Transcutaneous Lower Eyelid Blepharoplasty

  • Stephen W. Perkins
  • Paul K. HoldenEmail author
Chapter

Abstract

Lower eyelid rejuvenation is among the most common cosmetic operations performed. Surgeons should approach each patient with a careful analysis to determine the most appropriate procedure for rejuvenation of the lower eyelid complex. The transcutaneous approach to lower eyelid blepharoplasty is an important tool in the armamentarium of aesthetic surgeons. Properly executed, and in the appropriate patient, the procedure conveys no added risk of lower lid malposition over other common techniques. Premorbid lower eyelid malposition and/or laxity must be identified and addressed at the time of surgery. Several intraoperative maneuvers such as preservation of the pretarsal orbicularis oculi muscle, conservative resection of skin and muscle, and suspension of the tarsus and/or pretarsal orbicularis oculi muscle to the periosteum of the lateral orbital rim help minimize the risk of postoperative lower lid malposition. If the lower lid demonstrates laxity or poor tone preoperatively, then a lateral canthoplasty is performed in conjunction with lower lid blepharoplasty. Employing a standardized, logical approach to patients will ensure optimal outcomes for lower lid rejuvenation.

Keywords

Lower Eyelid Lateral Canthus Orbital Septum Scleral Show Subciliary Incision 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Honrado CP, Pastorek NJ. Long-term results of lower-lid suspension blepharoplasty: a 30-year experience. Arch Facial Plast Surg. 2004;6(3):150–4.CrossRefGoogle Scholar
  2. 2.
    Rees TD. Prevention of ectropion by horizontal shortening of the lower lid during blepharoplasty. Ann Plast Surg. 1983;11(1):17–23.CrossRefGoogle Scholar
  3. 3.
    Flowers RS. Canthopexy as a routine blepharoplasty component. Clin Plast Surg. 1993;20(2):351–65.Google Scholar
  4. 4.
    Hirmand H et al. Prominent eye: operative management in lower lid and midfacial rejuvenation and the morphologic classification system. Plast Reconstr Surg. 2002;110(2):620–8; discussion 629–34.CrossRefGoogle Scholar
  5. 5.
    Patipa M. The evaluation and management of lower eyelid retraction following cosmetic surgery. Plast Reconstr Surg. 2000;106(2):438–53; discussion 454–9.CrossRefGoogle Scholar
  6. 6.
    Furnas DW. Festoons of orbicularis muscle as a cause of baggy eyelids. Plast Reconstr Surg. 1978;61(4):540–6.CrossRefGoogle Scholar
  7. 7.
    Furnas DW. Festoons, mounds, and bags of the eyelids and cheek. Clin Plast Surg. 1993;20(2):367–85.PubMedGoogle Scholar
  8. 8.
    Becker FF, Deutsch DB. Extended lower lid blepharoplasty. Facial Plast Surg Clin North Am. 1995;3:189–94.Google Scholar
  9. 9.
    Kikkawa DO, Lemke BN, Dortzbach RK. Relations of the superficial musculoaponeurotic system to the orbit and characterization of the orbitomalar ligament. Ophthal Plast Reconstr Surg. 1996;12(2):77–88.CrossRefGoogle Scholar
  10. 10.
    Garcia RE, McCollough EG. Transcutaneous lower eyelid blepharoplasty with fat excision: a shift-resisting paradigm. Arch Facial Plast Surg. 2006;8(6):374–80.CrossRefGoogle Scholar
  11. 11.
    Baker SR. Orbital fat preservation in lower-lid blepharoplasty. Arch Facial Plast Surg. 1999;1(1):33–7.CrossRefGoogle Scholar
  12. 12.
    Papel ID. Muscle suspension blepharoplasty. Facial Plast Surg. 1994;10(2):147–9.CrossRefGoogle Scholar
  13. 13.
    Bernardi C, Dura S, Amata PL. Treatment of orbicularis oculi muscle hypertrophy in lower lid blepharoplasty. Aesthetic Plast Surg. 1998;22(5):349–51.CrossRefGoogle Scholar
  14. 14.
    Loeb R. Naso-jugal groove leveling with fat tissue. Clin Plast Surg. 1993;20(2):393–400; discussion 401.PubMedGoogle Scholar
  15. 15.
    Kane MA. Treatment of tear trough deformity and lower lid bowing with injectable hyaluronic acid. Aesthet Plast Surg. 2005;29(5):363–7.CrossRefGoogle Scholar
  16. 16.
    Flowers RS. Tear trough implants for correction of tear trough deformity. Clin Plast Surg. 1993;20(2):403–15.PubMedGoogle Scholar
  17. 17.
    Kawamoto HK, Bradley JP. The tear “TROUF” procedure: transconjunctival repositioning of orbital unipedicled fat. Plast Reconstr Surg. 2003;112(7):1903–7; discussion 1908–9.CrossRefGoogle Scholar
  18. 18.
    Enzer YR, Shorr N. Medical and surgical management of chemosis after blepharoplasty. Ophthal Plast Reconstr Surg. 1994;10(1):57–63.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Meridian Plastic SurgeonsIndianapolisUSA
  2. 2.Holden Facial Plastic SurgeryScottsdaleUSA

Personalised recommendations