Cultural Differences in Pretarsal Fullness Acceptance

Putterman, Allen M. M.D.

Plastic & Reconstructive Surgery: April 2017 - Volume 139 - Issue 4 - p 1018e–1019e
doi: 10.1097/PRS.0000000000003195
Letters

Department of Ophthalmology, University of Illinois College of Medicine in Chicago, 111 North Wabash, Suite 1722, Chicago, Ill. 60602, drputterman@drputterman.com

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Sir:

I read with interest the article by Jeon et al.1 on pre tarsal augmented lower blepharoplasty. The authors indicated that pretarsal fullness is an attractive aspect of the lower eyelid and, in their article, they present a procedure to create this.

I attach a lateral lower eyelid orbicularis flap to the lateral orbital wall when I perform a midface lift and a lower eyelid plication blepharoplasty.2,3 At times, this creates a tightening of the pretarsal orbicularis and a subsequent fullness of the pretarsal area. Most of my Caucasian patients find this to be unacceptable, and I then have to treat this with either excision of the thickened orbicularis or botulinum toxin type A injections into it. I point this out, as I suspect there may be a cultural difference in what is considered attractive with the authors’ procedure.

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ACKNOWLEDGMENT

The author is supported by an unrestricted grant from Research to Prevent Blindness, New York, N.Y. (EY001792).

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DISCLOSURE

The author has no financial interest to declare in relation to the content of this communication.

Allen M. Putterman, M.D.

Department of Ophthalmology

University of Illinois College of Medicine in Chicago

111 North Wabash, Suite 1722

Chicago, Ill. 60602

drputterman@drputterman.com

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REFERENCES

1. Jeon YR, Rah DK, Lew DH, Roh TS, Kim YS, Choi HLPretarsal augmented lower blepharoplasty. Plast Reconstr Surg. 2016;138:74–82
2. Putterman AFagien SCheek/mid-facelift. In: Putterman’s Cosmetic Oculoplastic Surgery. 2008:4th ed. Philadelphia: Saunders/Elsevier; 187–204.
3. Putterman AMPutterman AMLateral canthal plication. In: Cosmetic Oculoplastic Surgery. 1999:3rd ed. Philadelphia: Saunders; 221–228.
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