Orbicularis muscle position during lower blepharoplasty with fat repositioning

Area of Science:

• Oculoplastic surgery
• Facial rejuvenation surgery
• Anatomical studies of the periorbital region

Background:

• The tear trough is a key anatomical landmark defining the eyelid-cheek junction.
• Lower eyelid blepharoplasty aims to address aging signs in the midface.
• Supraperiosteal fat repositioning is a technique used in lower blepharoplasty.

Purpose of the Study:

• To quantify intraoperative changes in the orbicularis muscle edge position.
• To evaluate the effect of supraperiosteal fat repositioning on the tear trough.
• To assess the clinical relevance of muscle elevation in lower eyelid blepharoplasty.

Main Methods:

• Thirty patients underwent transconjunctival lower eyelid blepharoplasty with supraperiosteal fat repositioning.
• Intraoperative measurements of the orbicularis muscle edge elevation were performed using a "dipstick" method.
• Data on patient demographics, surgical variations, follow-up, and complications were collected.

Main Results:

• The orbicularis muscle edge showed an average elevation of 8.8 mm (range, 6-12 mm) above the orbital rim.
• Bilateral measurements were highly consistent, with 24 patients showing less than 1 mm difference.
• No significant difference in muscle elevation was observed between externalized and internal suture fixation methods.

Conclusions:

• Supraperiosteal fat repositioning significantly elevates the orbicularis muscle edge.
• This elevation enhances the eyelid-cheek interface, crucial for tear trough correction.
• The technique shows promise for improving aesthetic outcomes in lower eyelid and midface aging.