Review ArticleLower Eyelid Anatomy An UpdateKakizaki, Hirohiko MD, PhD*†‡; Malhotra, Raman FRCOphth†; Madge, Simon N. MRCP, FRCOphth‡; Selva, Dinesh FRANZCO‡ Author Information From the *Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi,Japan; †Corneoplastic Unit and Eye Bank, Queen Victoria Hospital NHS Trust, East Grinstead, West Sussex RH19 3DZ, United Kingdom; and ‡South Australia Institute of Optholmology and Discipline of Optholmology and Visual Sciences, University of Adelaide, South Australia, Australia. Received July 19, 2008, and accepted for publication, after revision, August 30, 2008. Reprints: Hirohiko Kakizaki, MD, PhD, Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi 480-1195, Japan. E-mail: [email protected]. Annals of Plastic Surgery: September 2009 - Volume 63 - Issue 3 - p 344-351 doi: 10.1097/SAP.0b013e31818c4b22 Buy Metrics Abstract The gross anatomy of the lower eyelid is analogous to that of the upper eyelid, however, the lower eyelid has a more simplified structure with less dynamic movement. Common malpositions of the lower eyelid include entropion and ectropion, rehabilitative surgery of which requires a thorough understanding of lower eyelid anatomy. Furthermore, precise anatomic knowledge is a prerequisite for both reconstructive and cosmetic lower eyelid surgery in order for it to be performed appropriately. In this review, we present the clinical anatomy of the structures of the lower eyelid, as well as highlighting relevant surgical implications. Featured here are the structure of the different eyelid lamellae, the lower eyelid retractors and their relations, the orbital septum, fat pad compartments, and Lockwood ligament. © 2009 Lippincott Williams & Wilkins, Inc.