Transcutaneous Lower Eyelid Blepharoplasty with Skin-Muscle Flap and Orbicularis Muscle Suspension

Understanding surgical anatomy is crucial for facial plastic surgeons performing blepharoplasty. This article highlights the senior author's 41-year experience with transcutaneous lower eyelid blepharoplasty, emphasizing techniques for optimal results and minimal complications. Key elements include meticulous incisions, hemostasis, fat management, and orbicularis muscle suspension. Postoperative care focuses on preventing complications and expediting healing. Comparative studies indicate both approaches yield good results but with some limitations to the best cosmetic outcomes with the transconjunctival approach in many patients. Proper techniques in both approaches are essential for optimal eyelid positioning.