Midface restoration in the management of the lower eyelid

Aging of the midface and lower eyelid represents one of the earliest clinically detectable areas of aging on the face. These senile changes include laxity of eyelid skin, pseudoherniation of orbital fat, ptosis of the suborbicularis oculi and malar fat pads, and loss of facial volume. Several approaches, including surgical and nonsurgical procedures, have been developed to counter the effects of aging on the midface and lower eyelid. This article reviews the techniques used by the authors to rejuvenate the midface and lower eyelid, and illustrates a comprehensive approach to management of this complex facial region.