Aim: Transcutaneous lower blepharoplasty is more convenient
for its easier learning curve, its better visibility and
access to the lower periorbital structures. Conventional techniques
entail fat removal to improve the lower eyelid contour.
In this study we adopted the extended transcutaneous lower
eyelid blepharoplasty that included dissection below the extent
of the inferior orbital margin to correct the tear trough deformity
that is usually missed in traditional techniques.
Methods: From December 2017 to December 2018, 25
patients were subjected to this procedure via a transcutaneous
stair-step incision. A retrospective analysis was implemented.
On the medial side, palpebral, orbital orbicularis oculi muscle
and the orbitomalar ligament were freed with dissection
approaching to the premaxillary space. On the lateral side,
release of the orbitomalar ligament was done, followed by
dissection reaching to the prezygomatic space. Fat pads were
dealt with either by excision or redistribution.
Results: The mean follow-up was 12 months. High degree
of patient's satisfaction was noted after using this technique.
No major complications in term of lid malposition or scleral
show or infection.
Conclusion: Extended transcutaneous lower blepharoplasty
is a safe and effective approach and a very powerful modality
for blending the lid-cheek junction and periorbital rejuvenation.
Level of Evidence: Therapeutic, V.