Long Term Results of Minimal Access Lower Lid Blepharoplasty
Lower eyelid blepharoplasty is a powerful procedure for periorbital rejuvenation. The two reported lower lid blepharoplasty techniques include the transconjunctival and subcilliary approaches, both of which can have the serious consequence of lower lid ectropion. An alternative technique of minimal access lower lid recontouring was previously described in 2013 with zero incidence of lower lid retraction at that time. This approach allows for no incision in the functional muscle in the anterior or posterior lamella of the central lid. The purpose of this study was to evaluate the 13-year experience of this technique in regard to aesthetic outcome and lower lid retraction.
Methods/Technique:
A retrospective review was performed from a single surgeon’s practice of patients who underwent minimal lateral access lower lid recontouring for eyelid rejuvenation over a 13-year period. Patients with at least 6 months follow up were evaluated for complications and patient satisfaction. This minimal access technique is carried out through a small lateral lower lid incision only. Fat is recontoured after the technique of Lobe with progressive muscle lifting after the technique of Hinderer.
Results/Complications:
Two hundred fifty-five patients underwent minimal access lower lid recontouring during the 13-year period. A total of 171 patients had at least 6 months follow up and were included in the study. There were 12 cases of secondary surgeries of lower eyelids including fat pad excision (N3), excess lower lid skin removal (N1), correction of contour recurrence issue (N1), scar revision (N3) and removal of prominent canthopexy suture (N4). There were no major complications including no instances of lower lid ectropion.
Conclusion:
This study demonstrates that minimal access lower lid blepharoplasty is a safe and effective way to recontour the lower lid. There is a very low revision rate and no instances of lower lid retraction. Additionally, one may conclude that avoidance of cutting functional muscle in the central lid with this technique may contribute to the zero incidence of lower lid retraction seen with this approach.