Management of Postblepharoplasty Lower Eyelid Retraction

Postblepharoplasty lower eyelid retraction is challenging and multifactorial and may occur after transcutaneous lower eyelid surgery. Surgical correction is difficult and unpredictable. Patient psyche is often negatively affected. This combination of events can limit patient satisfaction, so significant preoperative counseling to educate patients and modulate expectations is critical. The combination of midface lifting, implantation of a posterior lamellar spacer graft, and canthal suspension (standard surgery) has led to variable degrees of functional and aesthetic improvement. This article reviews the typical presentation, outlines the steps of standard surgery, and touches on other modalities of treatment that may improve patient satisfaction.