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Related Experiment Video

Updated: Apr 16, 2026

Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
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Stop Blaming the Septum.

Robert Schwarcz1, John P Fezza, Andrew Jacono

  • 1*Division of Oculoplastic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; †Center for Sight, Sarasota, Florida; ‡Department of Ophthalmology, University of South Florida, Tampa, Florida; §Facial Plastic and Reconstructive Surgery, North Shore University Hospital, Manhasset, New York; ‖Facial Plastic Surgery, Albert Einstein College of Medicine, Bronx, New York; ¶New York Center for Facial Plastic and Laser Surgery, Great Neck, New York; #Division of Oculoplastic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California; **Beverly Hills Ophthalmic Plastic and Reconstructive Surgery, Beverly Hills, California; and ††The Facial Paralysis Institute, Beverly Hills, California, U.S.A.

Ophthalmic Plastic and Reconstructive Surgery
|February 27, 2015
PubMed
Summary
This summary is machine-generated.

Isolated orbital septum scars do not cause lower eyelid retraction after blepharoplasty. Multilamellar scarring, not middle lamellar scarring, is more likely responsible for post-surgical eyelid changes.

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Area of Science:

  • Ophthalmology
  • Plastic Surgery

Background:

  • Lower eyelid retraction is a potential complication following blepharoplasty.
  • The role of orbital septum scarring in this complication is debated.

Purpose of the Study:

  • To determine if isolated surgical violation of the orbital septum leads to "middle lamellar" scarring.
  • To assess if this scarring subsequently causes postblepharoplasty lower eyelid retraction.

Main Methods:

  • Retrospective review of patients undergoing transconjunctival blepharoplasty (postseptal vs. preseptal planes).
  • Exclusion of patients with skin excision, muscle plication, or canthal suspension.
  • Assessment of postoperative lower eyelid retraction and forced superior eyelid excursion.

Main Results:

  • 576 eyelids from 288 patients were evaluated (55% postseptal, 45% preseptal).
  • No patient complaints or physician-assessed retraction were noted.
  • Only one case (0.5%) showed positive forced traction testing, linked to infection-related scarring.

Conclusions:

  • "Isolated" orbital septal scars (middle lamellar scars) are unlikely to cause lower eyelid retraction post-blepharoplasty.
  • The term "multilamellar scar" is a more fitting description for scars leading to retraction.