What it means for a patient
- If you have lower eyelid surgery with your facelift, ask whether the outer corner of the eye will be supported.
- In this series, 3.5% needed another operation for lid position, and 11.7% had a minor revision for other reasons.
- Eye surface swelling after surgery occurred in 12.1% of patients.
- This is one surgeon's retrospective series without a comparison group of patients who did not get canthal support.
Why this paper matters
It reported complication rates over 10 years for transcutaneous lower blepharoplasty with routine lateral canthal support. The authors recommend canthal support as a routine part of this operation and call the complication rate acceptable.
Overview
Lower eyelid surgery through a skin incision can tighten skin and muscle and treat fat, but it carries a risk of the lower lid pulling down out of position. Routine support of the outer eye corner had been advised to lower this risk. The authors reviewed one surgeon's 10-year series of first-time lower blepharoplasty with canthopexy, canthoplasty and orbicularis suspension.
Findings
- Retrospective chart review, 10 years; patients with prior eyelid surgery or midface lift excluded.
- Charts and standardized photos reviewed by an independent observer.
- 264 patients; median follow-up 264 days (range 60 to 2,410 days).
- Lid malposition needing surgical correction: 9 patients (3.5%).
- Orbital hematoma: 1 patient (0.4%).
- Chemosis (swelling of the eye surface): 32 patients (12.1%).
- Blepharitis: 10 patients (3.8%).
- Minor revisions unrelated to lid position: 31 patients (11.7%), for incision cysts or granulomas, canthal suture inflammation and canthal webbing.
Terms
- Transcutaneous lower blepharoplasty: lower eyelid surgery through an incision just below the lashes.
- Lateral canthus: the outer corner of the eye.
- Canthopexy: stitching the outer eye corner to bone to support it.
- Canthoplasty: cutting and resetting the outer eye corner tendon.
- Lid malposition: the lower eyelid pulling down or away from the eye.
- Chemosis: swelling of the clear membrane over the white of the eye.
- Blepharitis: inflammation of the eyelid edges.
- Canthal webbing: a fold of skin at the outer eye corner.