Modification of the cutaneous muscular flap approach for lower blepharoplasty

A modification of the cutaneous muscular flap approach for the treatment of baggy, wrinkled lower eyelids is presented. According to its anatomy, the pretarsal muscle is left intact when the flap is raised. This muscle is not directly related to fat bags and left in its place contributes in maintaining the normal lid physiology and avoids the complications seen with the original procedure.