Transcutaneous Lower Eyelid Blepharoplasty Research Articles

Measurement of Change in Lower Eyelid Position in Patients Undergoing Transcutaneous Skin-Muscle Flap Lower Eyelid Blepharoplasty

Transcutaneous lower eyelid blepharoplasty is a commonly performed procedure with a postoperative risk of eyelid malposition. To quantify the change in lower eyelid position after transcutaneous lower eyelid blepharoplasty. This retrospective medical record review describes patients who underwent transcutaneous blepharoplasty at a private facial plastic surgery practice. Patients with less than 3 months of follow-up, a history of periocular trauma, and concurrent midface lift were excluded. Bilateral skin-muscle flap lower eyelid blepharoplasties with possible tarsorrhaphy, canthopexy, or canthoplasty as indicated. Lower eyelid position determined by measurement of preoperative and postoperative pupil to eyelid and lateral limbus to eyelid distances. Data from 100 consecutive patients (mean age, 56.7 years; 92 female [92.0%]) undergoing bilateral skin-muscle flap lower eyelid blepharoplasty were analyzed. The mean increase in distance was 0.33 mm (95% CI, 0.24-0.42 mm) from the pupil to the lower eyelid margin and 0.32 mm (95% CI, 0.23-0.41 mm) from the lateral limbus to the lower eyelid margin at final follow-up. For both measurements, patients undergoing concurrent canthopexy had a significantly greater change in eyelid position (P < .001). Men had a greater change in the distance of pupil to lower eyelid compared with women (0.76 mm; 95% CI, 0.44-1.08 mm, vs 0.30 mm; 95% CI, 0.20-0.39 mm, respectively; P = .008) at final follow-up. Two patients required revision procedures secondary to eyelid malposition, and 25 patients had new onset of dry eye symptoms. Transcutaneous skin-muscle lower eyelid blepharoplasty with selective performance of canthoplasty or canthopexy causes a small, predictable eyelid position change in this population with a low rate of revision procedures. 3.

Mechanical Oscillopsia After Lower Eyelid Blepharoplasty With Fat Repositioning

Blepharoplasty with fat repositioning is a technique used to fill the tear trough in the aging lower eyelid. We describe a patient who underwent transcutaneous lower eyelid blepharoplasty with fat repositioning who subsequently developed mechanical oscillopsia in the right eye exacerbated by facial movement. Surgical exploration revealed cicatrix between the inferior oblique muscle and the anterior superficial musculoaponeurotic system. Excision of the scar bands led to immediate amelioration of symptoms. When performing blepharoplasty with fat repositioning, it is essential to be aware of the anatomic location of the inferior oblique in the anterior inferomedial orbit to avoid incarceration of this muscle.

Transcutaneous Lower Eyelid Blepharoplasty with Orbitomalar Suspension: Retrospective Review of 212 Consecutive Cases

Transcutaneous Lower Eyelid Blepharoplasty with Orbitomalar Suspension: Retrospective Review of 212 Consecutive Cases

Transcutaneous Lower Eyelid Blepharoplasty with Orbitomalar Suspension: Retrospective Review of 212 Consecutive Cases

Midfacial aging is associated with increased demarcation of the nasolabial, malar, and nasojugal folds; deflation of facial soft tissues and bones; and descent of the midface. The latter is primarily attributable to attenuation of the orbitomalar ligament. Traditional surgery of the lower eyelid and midface often requires removal of excess skin, orbicularis oculi muscle, and orbital fat, which can be complicated by postoperative lower eyelid malposition. The authors describe a novel adjunct to transcutaneous lower eyelid blepharoplasty that rejuvenates the lower eyelid and midface by reconstituting the orbitomalar ligament and minimizes the development of postoperative eyelid malposition. This study was a retrospective, consecutive, nonrandomized, interventional case series. The authors reviewed the medical records of 212 consecutive patients who underwent transcutaneous lower eyelid blepharoplasty with orbitomalar suspension. The aesthetic outcome, patient satisfaction, and development of eyelid malposition were evaluated. Transcutaneous lower eyelid blepharoplasty with orbitomalar suspension resulted in improved lower eyelid dermatochalasis, contour, midfacial ptosis, and appearance of the nasojugal and malar folds. All patients reported satisfaction with the aesthetic outcome. One patient (0.5 percent) developed lower eyelid retraction requiring subsequent lower eyelid tightening. Three patients (1.4 percent) developed transient lagophthalmos from lower eyelid orbicularis paresis that resolved spontaneously. Transcutaneous lower eyelid blepharoplasty combined with orbitomalar suspension is a powerful technique that can be performed concomitantly with facial rejuvenative procedures. Orbitomalar suspension addresses midfacial ptosis by restoring the natural function of the orbitomalar ligament and minimizes the development of postoperative lower eyelid malposition.