Three-Step Technique for Lower Lid Blepharoplasty

  • Joseph A. MaurielloJr.


The three-step technique for lower lid blepharoplasty has been utilized and modified since 1998.1, 2, 3, 4 It produces predictable results. Three and one-half mm of elevation of the eyelid/cheek skin interface is achieved.1, 2, 3, 4 The steps include:
  • Transconjunctival removal of orbital fat

  • “V7” suture lateral lower eyelid horizontal tightening technique after creation of the eyelid (skin muscle)-cheek flap with the carbon dioxide laser

  • Resuspension of the anterior lamella and adjacent malar fat pad to the lateral orbital periosteum


Eyelid Margin Orbicularis Muscle Skin Muscle Skin Interface Defocused Laser 
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  1. 1.
    Mauriello JA. Surgical technique: three-step technique for lower blepharoplasty. Ophthal Plast Reconstr Surg 2003;19:470–476.CrossRefPubMedGoogle Scholar
  2. 2.
    Mauriello JA. Upper and lower blepharoplasty with combined blepharoptosis repair. In: Mauriello JA (ed.). Techniques of Cosmetic Eyelid Surgery. A Case Study Approach. Lippincott Philadelphia: Williams & Wilkins, 2004: 28–66.Google Scholar
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    Mauriello JA. Three-step technique for lower blepharoplasty. Annual Spring Meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgery, Ponte Vedre, FL, June 17, 2004.Google Scholar
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    Mauriello JA. Check elevation and reduction of malar folds with minimal skin excision by treating the orbicularis oculi muscle with carbon dioxide laser during dosmetic lower blepharoplasty. Poster Presentation, American Society of Ophthalmic Plastic and Reconstructive Surgery, Chicago, IL, October 14–15, 2005.Google Scholar
  5. 5.
    Seckel BR, Kovanda CJ, Cetrulo CL, Passmore AK, Meneses PG, White T. Laser blepharoplasty with transconjunctival orbicularis muscle/septum tightening and periocular skin resurfacing: a safe and advantageous technique. Plast Reconstruc Surg 2000;106:1121–1141.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Joseph A. MaurielloJr.
    • 1
  1. 1.University of Medicine and Dentistry of New JerseySummitUSA

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