Blepharoplasty is one of the most commonly performed aesthetic procedures in the United States with more than 145,000 procedures performed in 2017 alone, representing a 26.3% increase compared with the previous year.1 Unlike upper eyelid blepharoplasty, which has seen only minor refinements to techniques in recent years, lower eyelid blepharoplasty techniques and strategies continue to evolve.2
Traditional lower eyelid blepharoplasty, performed through an external incision, has been shown to yield excellent aesthetic results.2 Some argue that the risk of lower lid malposition using this technique is significant and that prophylactic concomitant canthal procedures should be performed, the most notable of which are canthopexy or canthoplasty.3–7 Similarly, others perform lateral canthal procedures at the time of lower blepharoplasty to help maintain overall eyelid shape.8 In contrast, some surgeons attempt to circumvent lower eyelid pull-down and malposition by performing fat removal or transposition through a transconjuctival incision.9,10 To date, there is no consensus on optimal technique, and the evidence-based literature appears to be lacking in long-term follow-up adequate enough to capture the true timing and rate of recurrence and/or revisionary procedures.
Thus, despite large case series publishing excellent results and minimal complications, the true longevity of these procedures remains unclear. Lower blepharoplasty is performed by surgeons from multiple specialties, with no central agreement in terms of sufficient patient follow-up. The purpose of this study is to review the literature, paying special attention to published postoperative photographs in order to gain a better understanding of the longevity of this commonly performed procedure in the hope that we will be better able to educate our patients preoperatively. ….
If you want to know more about blepharoplasty, please read the Aesthetic Society article, July 2018