Suspending sutures in blepharoplasty

Lateral canthopexy using permanent suspending sutures to shorten the lateral canthal tendon helps prevent scleral show, increased sloping of the upper lid, and inferomedial displacement of the lateral canthus following lower lid blepharoplasty. While these complications usually are prevented by flap suspension techniques, in which more skin is excised above and lateral to the commissure than below it, sutures running from the inferomedial part of the lateral canthal tendon to its superolateral aspect and to periosteum just inside the orbit still further reduce the tendency toward the complications mentioned. We report technical aspects and results. After several years of clinical experience, we have the impression that the technique is a useful adjunct, even though it may produce more swelling and inflammation and a longer recuperative period.