Take, Give, and Peel

Abstract

Surgeons performing lower eyelid blepharoplasties continue to seek an efficient method and predictable outcome to restore the aesthetic ideal of the lower eyelid and cheek junction. Current popular methods frequently fall short. Three patients were chosen as examples from the senior author’s past 30 years of practice where they desired improvement in the aesthetic appearance of their lower eyelids. They were treated with a combination of transconjunctival blepharoplasty, fat grafting, and 88% phenol peel. The preoperative and postoperative photos of the patients were analyzed by the patient and senior author. Having undergone the methods described for treatment, all selected patients reported significant improvement with their postoperative appearance. Minimal complications were reported and are mentioned below. No surgical revisions were requested, and the results were stable over an acceptable period of time with an average follow-up time of 2 years. Two of the 3 patients chosen had a follow-up time of at least 8 years. Transconjunctival lower eyelid blepharoplasty when combined with fat grafting and phenol peeling offers a treatment modality to restore the aesthetic ideal of the lower eyelid and cheek junction and, in our hands, is superior to other methods previously described.