PURPOSE:
The current concept of lower blepharoplasty is to recontour the patient’s periorbital area. The age-related changes of malar descent, tear trough deformity, bulging fat, lid laxity, and skin texture changes as well as dermatochalasis and festoons should be identified according to the patients. We provide the personal algorithm about 3-dimentional contouring in lower blepharoplasty.
METHODS AND MATERIALS:
We evaluated 520 consecutive patients who underwent lower blepharoplasty between 2014 and 2019 retrospectively. All procedures were performed by a single surgeon (L.W.C). These techniques include release of retaining ligaments, fat transposition, orbicularis suspension, lateral canthal tightening, malar suspension, pretarsal fullness forming and midface volume augmentation via transconjunctival or transcutaneous and combined approaches. The outcomes and complications were assessed by evaluating the patients' preoperative and postoperative digital photographs and medical records.
RESULTS:
There were no major complications, such as retrobulbar hemorrhage, diplopia, or hypertrophic scarring. All patients were satisfied with their results. Our technique provided a natural and younger appearance via the algorithmic approach.
CONCLUSIONS:
The goal of our algorithmic approach for lower lid blepharoplasty is to smooth the lid–cheek junction, restore youthful contour and volume, at the same time minimize risk. Performing lower lid blepharoplasty effectively to yield a more natural and harmonious rejuvenation of the face, the awareness of the indications, alternative treatments, preoperative considerations, operative techniques, and management the associated complications are important.
REFERENCES
1. Chen MC, Ma H, Liao WC. Anthropometry of pretarsal fullness and eyelids in oriental women. Aesthetic Plast Surg. 2013 Jun;37(3):617-24
2. Rohrich RJ, Mahedia M, Hidalgo D, Shah N. The Evolving Role of Blending of the Lid-Cheek Junction in Lower Blepharoplasty. Plast Reconstr Surg. 2018;142(2):377-382.
3. Core GB. Lateral access recontouring blepharoplasty for rejuvenation of the lower lids Plast Reconstr Surg. 2013 Oct;132(4):835-42.

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