The five-step lower blepharoplasty: blending the eyelid-cheek junction

Area of Science:

• Oculoplastic surgery
• Facial plastic surgery
• Aesthetic surgery

Background:

• Lower lid blepharoplasty complications and suboptimal aesthetic results can arise from disregarding orbicularis oculi muscle anatomy.
• A simplified, anatomically-based five-step technique is presented to address these challenges.
• This approach aims to encourage surgeons to perform essential periorbital rejuvenation maneuvers.

Purpose of the Study:

• To present and evaluate a simplified, five-step clinical approach for lower lid blepharoplasty.
• To assess the efficacy of this technique in improving lower eyelid aesthetics and reducing complications.

Main Methods:

• A retrospective review of 50 patients (100 lower eyelids) who underwent primary lower lid blepharoplasty using the five-step technique.
• Digital images were analyzed using a computer program with standardized data points converted to ratios to measure aesthetic parameters.

Main Results:

• The five-step technique demonstrated low complication rates across 100 analyzed lower eyelids.
• Significant improvements were observed in tear trough width and position, lower lid position relative to the pupil, and intercanthal angle.
• No cases of lower lid malposition were reported.

Conclusions:

• Aesthetic outcomes in lower lid blepharoplasty are enhanced by a five-step technique addressing anatomical findings.
• Key steps include augmenting the deep malar fat compartment, preserving orbicularis oculi muscle, selectively releasing the orbicularis retaining ligament, strengthening lateral canthal support, and minimal skin excision.
• This method leads to improved periorbital rejuvenation with favorable aesthetic results and low complication rates.