摘要

Objectives: Discuss a personal approach to addressing lower eyelid aging Introduction: Lower eyelid aging is a complex situation involving skin, muscle, fat and bone. Underlying conditions such as orbital rim recession and festoons must be analyzed as well. Materials / method: We routinely perform lower blepheroplasty alone, in conjunction with upper blepheroplasty, brow lifting and face and neck lifting surgery. Results: The simplest approach is a pinch lower blepheroplasty often in conjunction with peri-orbital fat grafting. A transcutaneous lateral canthopexy is often performed. More extensive intra-orbital fat protrusion requires either tranconjunctival or a Jelks, no touch approach with transcutaneous blepheroplasty. Lateral canthopexy is routinely carried out. Midface and/or cheek lifts are necessary in most patients with negative vector. Conclusion: Lower blepheroplasty may be a simple or quite challenging procedure. Surgical judgement and conservatism are especially important. Application of numerous techniques are needed to achieve the optimal results with the lower complication risks.