The University of Texas Southwestern Medical Center has introduced a new approach to blepharoplasty that specifically addresses complicated rejuvenation of the lower eyelid. The new process, which is documengted in a recent edition of the journal Plastic and Reconstructive Surgery, has been proven through 100 eyelid procedures and one-year-post-procedure follow-ups with patients.
“Along with the front of the neck, the eye area of the face is the first thing you look at when you meet a person, and one of the first features that reveals your age,” says Rod Rohrich, MD. “Plastic surgery of the lower lid historically is challenging and has inspired a confusing spectrum of surgical techniques. This new process is designed to simplify some of the complexities and give us better, more consistent results.”
Blepharoplasty is often performed along with a face lift but according to Rohrich some surgeons avoid lower lid rejuvenation because of the potential for long-lasting complications and an unnatural look if it’s not done correctly. He hopes the simplicity of the new process will encourage more plastic surgeons and reconstructive surgeons to provide this service to their patients. Eyes look old when they sag, bulge, wrinkle, and hollow.
In Rohrich’s experience, younger patients who request plastic surgery of the eyes have noticed a change in the shape of the eye, including the beginnings of bulging lower eyelid fat, which gives them a tired look. Older patients often complain of sagging skin and excess wrinkling, which also makes their eyes look tired.
One of the reasons eyes look old is that fat pockets in the face begin to deflate and change shape, with separations forming between them, which makes transition zones like the lower lid/cheek junction more obvious. This phenomenon is more marked in men than in women. A blepharoplasty attempts to shift the fat pockets and skin to restore the eye to its original shape—or as close as possible based on past photos of the person.
The five-step eye lift procedure simplifies the process. The rejuvenation process is composed of simple individual technical maneuvers combined to provide a powerful, reproducible eyelid shaping approach for surgeons.
The five steps include the following:
1. Augmenting the supportive deep malar fat compartment in the cheek by injection
2. Preserving the lower lid muscle with minimal fat removal (if at all)
3. Selectively releasing the main ligament structure of the lower lid
4. Establishing or strengthening the lateral canthal support
5. Removing minimal skin