The "Eyelid Lift" in Lower Blepharoplasty Surgery.

Esthetic rejuvenation of the periocular area is an effective intervention to address facial aging and tired eyes.1 The importance of the lower eyelids, located crucially in the center of the face, cannot be underestimated. Lower eyelid aging is influenced by gravity and globe weight, responsible for the various clinical manifestations that can be subclassified as: (1) volume changes, represented by eyelid bags and orbito-malar hollowing; (2) skin changes, including skin excess and descent; (3) laxity changes, manifested by eyelid margin rounding, infero-lateral scleral show, lateral canthal angle medialization, and negative canthal tilt. Laxity changes, by widening the youthful narrow palpebral fissure, further contribute to loss of perceived attractiveness.2 Lower blepharoplasty is a commonly performed aesthetic oculoplastic surgical procedure. Traditionally, lower blepharoplasty surgery focused mainly on addressing volume changes and skin excess to achieve effacement of the eyelid/cheek junction with most authors advocating routine adjunctive ancillary procedures to prevent downward displacement of the lower eyelid.3 The authors believe that the added risks of these supporting procedures can overcome the potential benefits and should ideally be avoided at the time of primary blepharoplasty. The authors have previously reported a lower blepharoplasty surgical technique that mimics the effect of digital elevation of the eyelid skin, hence the name “Eyelid Lift,” which addresses volume, skin, and laxity changes simultaneously, whilst at the same time avoiding adjunctive supportive procedures.4