Smoothening the Lid-cheek Junction in Lower Blepharoplasty.

Abstract

Aim: Transcutaneous lower blepharoplasty is more convenient for its easier learning curve, its better visibility and access to the lower periorbital structures. Conventional techniques entail fat removal to improve the lower eyelid contour. In this study we adopted the extended transcutaneous lower eyelid blepharoplasty that included dissection below the extent of the inferior orbital margin to correct the tear trough deformity that is usually missed in traditional techniques.Methods: From December 2017 to December 2018, 25 patients were subjected to this procedure via a transcutaneous stair-step incision. A retrospective analysis was implemented. On the medial side, palpebral, orbital orbicularis oculi muscle and the orbitomalar ligament were freed with dissection approaching to the premaxillary space. On the lateral side, release of the orbitomalar ligament was done, followed by dissection reaching to the prezygomatic space. Fat pads were dealt with either by excision or redistribution. Results: The mean follow-up was 12 months. High degree of patient’s satisfaction was noted after using this technique. No major complications in term of lid malposition or scleral show or infection.Conclusion: Extended transcutaneous lower blepharoplasty is a safe and effective approach and a very powerful modality for blending the lid-cheek junction and periorbital rejuvenation.Level of evidence: Therapeutic, V.