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.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
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.
Rees TD. Prevention of ectropion by horizontal shortening of the lower lid during blepharoplasty. Ann Plast Surg. 1983;11(1):17–23.
Flowers RS. Canthopexy as a routine blepharoplasty component. Clin Plast Surg. 1993;20(2):351–65.
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.
Patipa M. The evaluation and management of lower eyelid retraction following cosmetic surgery. Plast Reconstr Surg. 2000;106(2):438–53; discussion 454–9.
Furnas DW. Festoons of orbicularis muscle as a cause of baggy eyelids. Plast Reconstr Surg. 1978;61(4):540–6.
Furnas DW. Festoons, mounds, and bags of the eyelids and cheek. Clin Plast Surg. 1993;20(2):367–85.
Becker FF, Deutsch DB. Extended lower lid blepharoplasty. Facial Plast Surg Clin North Am. 1995;3:189–94.
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.
Garcia RE, McCollough EG. Transcutaneous lower eyelid blepharoplasty with fat excision: a shift-resisting paradigm. Arch Facial Plast Surg. 2006;8(6):374–80.
Baker SR. Orbital fat preservation in lower-lid blepharoplasty. Arch Facial Plast Surg. 1999;1(1):33–7.
Papel ID. Muscle suspension blepharoplasty. Facial Plast Surg. 1994;10(2):147–9.
Bernardi C, Dura S, Amata PL. Treatment of orbicularis oculi muscle hypertrophy in lower lid blepharoplasty. Aesthetic Plast Surg. 1998;22(5):349–51.
Loeb R. Naso-jugal groove leveling with fat tissue. Clin Plast Surg. 1993;20(2):393–400; discussion 401.
Kane MA. Treatment of tear trough deformity and lower lid bowing with injectable hyaluronic acid. Aesthet Plast Surg. 2005;29(5):363–7.
Flowers RS. Tear trough implants for correction of tear trough deformity. Clin Plast Surg. 1993;20(2):403–15.
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.
Enzer YR, Shorr N. Medical and surgical management of chemosis after blepharoplasty. Ophthal Plast Reconstr Surg. 1994;10(1):57–63.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Perkins, S.W., Holden, P.K. (2011). Transcutaneous Lower Eyelid Blepharoplasty. In: Massry, G., Murphy, M., Azizzadeh, B. (eds) Master Techniques in Blepharoplasty and Periorbital Rejuvenation. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0067-7_15
Download citation
DOI: https://doi.org/10.1007/978-1-4614-0067-7_15
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-0066-0
Online ISBN: 978-1-4614-0067-7
eBook Packages: MedicineMedicine (R0)