What are the procedures for lower blepharoplasty (blepharoplasty of the lower eyelid)?

From the Research

Lower blepharoplasty procedures should always include a thorough preoperative evaluation to minimize morbidity and optimize outcomes, as emphasized in the most recent study 1.

Key Considerations

• The procedure typically involves making an incision either just below the lash line (transcutaneous approach) or inside the eyelid (transconjunctival approach), followed by removal or repositioning of excess fat pads and sometimes tightening or removal of excess skin.
• The transconjunctival approach leaves no visible scar and is preferred for patients who primarily need fat removal without significant skin excision.
• Recovery generally takes 1-2 weeks, with bruising and swelling expected during this period.
• Patients should apply cold compresses for the first 48 hours, sleep with their head elevated, avoid strenuous activities for 2 weeks, and use prescribed antibiotic ointments to prevent infection.
• Complications can include temporary dry eyes, asymmetry, and rarely, ectropion (eyelid pulling down), which can be minimized with proper technique and patient selection, as highlighted in 2.

Surgical Techniques

• Lateral canthopexy is an effective procedure to minimize the risk of postsurgical ectropion, especially in older patients, as noted in 3.
• Canthopexy should be a routine companion or alternative to lower lid blepharoplasty to restore tone and youthful contour to the deteriorating eye, as suggested in 4.
• The necessity of canthopexy increases with the rising age of the patients, and it supports the lower lid position in the case of increasing vertical tension.

Patient Selection

• Candidates should be in good health without serious eye conditions and have realistic expectations about the outcome.
• Preoperative assessment of the lower lid function and laxity is crucial before performing a blepharoplasty, as emphasized in 5 and 1.
• The preoperative evaluation plays an important role in optimizing outcomes and minimizing morbidity for patients undergoing blepharoplasty, as highlighted in the most recent study 1.