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The Lift and Fill Lower Blepharoplasty

Massry, Guy G. M.D*; Hartstein, Morris E. M.D†,‡

Ophthalmic Plastic and Reconstructive Surgery: May/June 2012 - Volume 28 - Issue 3 - p 213–218
doi: 10.1097/IOP.0b013e318248e6a1
Surgical Technique
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Purpose: To evaluate a series of patients who underwent combined lower transconjunctival blepharoplasty with fat repositioning and orbicularis muscle suspension, “The Lift and Fill Lower Blepharoplasty,” as a means of improving lower eyelid, and eyelid/cheek interface aesthetics after surgery.

Methods: The authors retrospectively reviewed the charts of patients who underwent both transconjunctival lower blepharoplasty with fat repositioning and orbicularis muscle suspension over a 4-year period (2007–2010) from the 2 authors’ practices. All patients with a history of previous eyelid surgery or trauma, eyelid or orbital inflammatory disease, and those with frank eyelid malposition are excluded. Additional procedures are noted and results and complications are reviewed.

Results: The study consists of 54 patients, of whom 42 are women, with an average age of 56 years and an average follow up of 19 months. Thirty patients had fat repositioning performed subperiosteally, and in 24 patients the dissection plane was preperiosteal. A skin excision was added in most patients and canthal suspension in approximately half of the patients. There were no cases of postoperative eyelid malposition or other significant complications. There were no appreciable differences in outcomes between the sub- or preperiosteal fat repositioning approaches. All patients were happy with their surgical outcome.

Conclusion: The combination of transconjunctival lower blepharoplasty with fat repositioning, and orbicularis muscle suspension, “The Lift and Fill Lower Blepharoplasty,” provides a reliable and reproducible aesthetic rejuvenation of the lower eyelid and its transition to the cheek.

The “Lift and Fill Lower Blepharoplasty” combines fat preservation and orbicularis muscle suspension to effectively improve lower lid aesthetics and help efface the eyelid/cheek interface.

*Ophthalmic Plastic and Reconstructive Surgery, Spalding Dr. Cosmetic Surgery and Dermatology, Beverly Hills, California

Department of Ophthalmology and Division of Plastic Surgery, St. Louis University School of Medicine, St. Louis, Missouri, U.S.A.

Department of Ophthalmology, Assaf Harofeh Medical Center, Beer Yaacov, Israel

Accepted for publication December 27, 2011.

Presented at the American Society of Ophthalmic Plastic and Reconstructive Surgery 42nd Annual Fall Scientific Symposium in October 2011, Orlando, FL.

The authors have no financial or conflict of interest to disclose.

Address correspondence and reprint requests to Guy G. Massry, M.D., Spalding Dr. Cosmetic Surgery and Dermatology, Beverly Hills, CA 90212. E-mail: gmnassry@aol.com

©2012The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.