Summary
Background
The transconjunctival approach is commonly performed in lower lid blepharoplasty so
as not to violate the orbicularis oculi muscle integrity and avoid additional scars.
This technique does not, however, permit easy access to the lateral fat pad (LFP).
As upper and lower blepharoplasty are frequently combined in our clinical practice,
the removal of LFP via upper blepharoplasty is a surgical approach that we found most
applicable with good outcomes.
Methods
A prospective review of 47 consecutive bilateral combined upper and lower blepharoplasty
cases using a single access technique was conducted; patient outcomes and the occurrence
of any complications were recorded, in addition to preoperative and postoperative
measurements between standardized anatomical landmarks.
Results
Forty-seven patients were included in our study. Postoperative measurements showed
a decrease of both lateral cantus to inferior orbital border distance and horizontal
width of LFP. Good esthetic outcomes and patient satisfaction with surgical results
were achieved in the majority of patients.
Conclusion
The single access upper blepharoplasty and lower lid LFP removal technique can improve
esthetic outcomes in lower blepharoplasty. The advantages are many; a low risk of
missing the lateral pad, ease of achieving a uniform contour of lower eyelid; short
lower transconjunctival incision, minimizing complications associated with an intra-conjunctival
scar. This technique, based on cadaveric anatomical studies, has been found to be
safe and is of great utility to those patients requiring upper and lower lid blepharoplasties.
Keywords
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Article info
Publication history
Published online: August 22, 2022
Accepted:
August 16,
2022
Received:
August 31,
2021
Footnotes
Meeting presentation: 69° SICPRE National Congress, 23–25 September 2021.
Identification
Copyright
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
