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Transcutaneous skin-muscle flap lower eyelid blepharoplasty causes small eyelid position change

Patients undergoing bilateral transcutaneous skin-muscle flap lower eyelid blepharoplasties, with selective use of canthoplasty or canthopexy, experienced minor lower eyelid position change and a low revision rate, according to study results recently published in JAMA Facial Plastic Surgery.

Researchers conducted a retrospective medical review of 100 consecutive patients (92 females; mean age, 56.7 years) undergoing bilateral skin-muscle flap lower eyelid blepharoplasty at a private facial plastic surgery practice. Analysis was conducted using preoperative and postoperative photographs.

There was a mean follow-up of 10.7 months. Sixty-nine patients underwent fat transposition, 22 patients underwent canthopexy, and seven patients underwent canthoplasty.

The distance from the pupil to the lower eyelid margin increased by a mean of 0.33 mm (95% CI, 0.24-0.42). From the lateral limbus to the lower eyelid margin, the distance increased by 0.32 mm (95% CI, 0.23-0.41), according to the researchers.

There was a significantly greater change in eyelid position for patients undergoing concurrent canthopexy for both measurements (P < .001). Final follow-up results found that there was a significantly greater change in the distance of pupil to lower eyelid for men (0.76 mm; 95% CI, 0.44-1.08) compared with women (0.3 mm; 95% CI, 0.2-3.03).

Revision procedures secondary to eyelid malposition were required for two patients (2%), and 25 of the 82 patients without preoperative dry eye developed post-surgery dry eye symptoms.

“In the present study of 100 consecutive patients undergoing bilateral transcutaneous skin-muscle flap lower eyelid blepharoplasties with selective use of canthoplasty or canthopexy … the change in eyelid position in all patients from baseline to final follow-up was less than 0.5 mm,” the researchers wrote.

“Preservation of the pretarsal orbicularis, orbicularis suspension, and selective use of canthopexy and canthoplasty result in predictable lower eyelid positions,” the researchers concluded.  – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.