The lift and fill lower blepharoplasty

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.