Treatment of orbicularis oculi muscle hypertrophy in lower lid blepharoplasty

Treatment of orbicularis oculi muscle hypertrophy during conventional lower eyelid blepharoplasty is presented. Horizontal resection of a strip of the hypertrophic muscle is carried out, which allows flattening of the muscular bulge in an anteroposterior direction. Since no full-thickness vertical reduction is performed, this simple procedure is "free" from the risk of "scleral show" deformity, due to excessive muscle shortening, leaving a pleasant contour in the lower eyelid. The technique has been successfully employed in 27 cases of blepharoplasty, with separate skin and muscle flaps.