Minimal Access Lateral Approach in Lower Eyelid Blepharoplasty for Three-Dimensional Recontouring

Lower eyelid blepharoplasty has historically been approached from one of only two techniques, either the anterior subciliary incision or from the posterior transconjunctival approach. Both have been used with subtractive techniques of skin and fat resection in most cases and both have had issues with post operative lower lid retraction with scleral show, albeit less with the posterior approach. Lateral acces recontouring does not transgress either the anterior or posterior functional muscles of the lower lid and avoids damaging the innervation of the lower lid orbicularis. Thus the technoque has resulted in a zero incidence of slceral show in this series beginning in 2007. When combined with muscle lifting and fat preservation as recontouring techniques, and canthal support when indicated, it also provides excellent blending of the lid cheek junction for effective rejuvenation.