How to avoid lower eyelid malposition after blepharoplasty?

Objetivos: By the end of this presentation, participants will be able to: • Identify key anatomical risk factors and intraoperative techniques that prevent lower lid malposition post-blepharoplasty. • Apply evidence-based preoperative assessment protocols to select ideal candidates and minimize complications. • Implement postoperative management strategies to achieve optimal lid stability and aesthetic outcomes. Introducción: Lower eyelid malposition, including ectropion and scleral show, remains a challenging complication after lower blepharoplasty, with incidence rates of 1-18% reported in literature. This arises from disruption of the lower lid’s structural support, including the tarsoligamentous sling and orbicularis muscle. Despite advances in transconjunctival and skin-muscle flap techniques, malposition often stems from overlooked preoperative laxity, excessive skin excision, or inadequate canthal support. This report synthesizes critical “must-remember” principles to guide surgeons in preventing these issue Materiales / método: Preoperative snap-back test, distraction test, and pinch test for lid laxity assessment. • Intraoperative strategies: transconjunctival fat repositioning , and orbicularis retaining ligament preservation. • Postoperative Preoperative snap-back test, distraction test, and pinch test for lid laxity assessment. • Intraoperative strategies: Endoscopic periorbital rejuvenation transconjunctival fat repositioning , Resultados: Thorough patient selection for each technique minimizes lower eyelid malposition. Conclusión: Preventing lower lid malposition demands meticulous preoperative evaluation, conservative tissue handling, and reliable canthal reinforcement.