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The KS-Pexy

a novel method to manage horizontal lower eyelid laxity

Van Slyke, Aaron C. MD, MSc1; Carr, Lauren BSc1; Carr, Nicholas J. MD, FRCSC1

doi: 10.1097/PRS.0000000000006484
Original Article: PDF Only

Background: Patients with horizontal lower lid laxity undergoing lower lid blepharoplasty are at a high risk for lid malposition. Prophylactic correction of horizontal lower lid laxity during blepharoplasty may alleviate this risk. Here, we describe a novel lower lid blepharoplasty technique, the KS-Pexy, for correcting horizontal lower lid laxity.

Methods: All cases of KS-Pexy between September 2009 – June 2018 from an aesthetic practice were reviewed retrospectively. All patients were diagnosed with horizontal lower lid laxity and requested lower lid blepharoplasty for aesthetic concerns. Patient demographics, clinical presentation, procedure details, and intraoperative findings were analyzed.

Results: 62 patients underwent KS-Pexy by the senior author. The average follow-up was 41.1 months, ranging from 2-107 months. Thirteen patients had a negative vector, 54 patients received a KS-Pexy in combination with another facial procedure, and 14 patients had their KS-Pexy as a secondary procedure. The overall success rate was 96.8%. The complication profile was: chemosis (27.4%), new onset dry eyes persisting longer than 8 weeks (6.5%), temporary lower eyelid malposition (4.8%), lower eyelid malposition requiring surgical intervention (3.2%), poor scar quality (1.6%), lower lid abscess (1.6%), transient conjunctivitis (1.6%), lateral fat compartment swelling (1.6%), canthopexy dehiscence (1.6%), hordeolum (1.6%) and temporary V2 paresthesia (1.6%).

Conclusions: The KS-Pexy is an effective means to treat horizontal eyelid laxity prophylactically in patients requesting lower eyelid blepharoplasty for aesthetic reasons.

1. Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada

Financial Disclosure Statement: The authors have nothing to disclose.

This work has not been previously presented at a public forum

Financial Disclosure Statement: The authors have nothing to disclose.


Corresponding author: Aaron C. Van Slyke, MD, MSc, Division of Plastic Surgery, Burn and Trauma Unit, University of British Columbia (UBC) and Vancouver General Hospital, 2nd Floor, JPP 899 West 12th Avenue, Vancouver, BC, Canada. V5Z 1M9,

©2019American Society of Plastic Surgeons