Combined surgical approach for safe and effective rejuvenation of the lower eyelids

Abstract

Background: Blepharoplasty is among the most demanded plastic surgery procedures worldwide. The popularity of the eyelid surgical rejuvenation is closely related to the remarkable improvement in facial aesthetics that these procedures bring to the patients with relatively short recovery period. However, these surgical interventions are among the most challenging since form, function and aesthetics have to be equally considered, preserved and improved. This is particularly true when dealing with age-related changes of the lower eyelids. Objectives: To demonstrate the author’s personal approach for obtaining safe and reliable results in aesthetic lower eyelid surgical rejuvenation combining transconjunctival approach for fat bags resection and pinch technique for excess skin excision. Materials and Methods: A retrospective chart review was conducted encompassing patients who underwent aesthetic lower blepharoplasty performed by the author between January 2020 and January 2024 by using the above mentioned combined surgical technique (transconjunctival approach + pinch skin resection). A minimum follow-up of 9 months was set. Exclusion criteria included previous surgeries and non-surgical procedures on the lower eyelids and underlying eyelid pathologies and comorbidities that aff ect the eyelids.  Results: A total of 72 consecutive patients (mean age = 53.78 years; range: 34-70 years) underwent bilateral lower eyelid blepharoplasty for creation of youthful look and improving the quality of life. Out of them, 56 were female (n = 56; 77.78%) and 16 were male (n = 16; 22.22%). In fi ve of the cases simultaneous upper blepharoplasty was performed too. One of the cases presented a rare and distressing intraoperative side eff ect of the local anaesthetics – transient anisocoria. Analysis of the outcomes demonstrated signifi cant aesthetic improvement and high satisfaction rate among the patients presenting from mild to severe age-related deformities of the lower eyelids with no major complications in the series. Conclusions: The described combined surgical approach for lower eyelid surgical rejuvenation has shown to be safe and eff ective technique with high patient satisfaction rate. Since patient’s safety and diminishing surgical risks is fi rst priority in plastic surgery, this approach is recommended when fast and uneventful recovery with optimal outcome is aimed.