Facial Plast Surg 2021; 37(02): 198-204
DOI: 10.1055/s-0041-1724112
Original Article

An Update on Subciliary Lower Eyelid Blepharoplasty

Ozcan Cakmak
1  Department of Facial Plastic Surgery, Faceistanbul, Istanbul, Turkey
Ismet Emrah Emre
2  Department of Otorhinolaryngology, Acibadem University, Halkali Merkez Mahallesi Turgut Ozal Bulvari, Istanbul, Turkey
› Author Affiliations


The subciliary lower eyelid blepharoplasty has evolved considerably to create a more harmonious natural appearance with a fuller and unoperated look and also to minimize the complications. While lower eyelid malposition was very common in the past, now this complication is significantly reduced by attention to preoperative evaluation, meticulous surgical planning, precise surgical technique, and postoperative care. Various prophylactic maneuvers maintaining/strengthening lower lid support can be utilized to prevent lower lid malposition including preservation of the pretarsal orbicularis oculi muscle, conservative resection of skin and muscle, and suspension of the orbicularis oculi muscle and/or tarsus to the periosteum of the lateral orbital rim. The release of the orbicularis retaining ligament and surgical transposition of orbital fat over the rim rather than excision allows for smoothing of the lid-cheek junction, filling the tear trough deformity, and reducing the appearance of bulging fat in the lower eyelid. In this article the reader will find a comprehensive approach for achieving a smooth contour with gradual blending at the lower eyelid–cheek junction while maintaining/restoring normal lower lid support. A descriptive outline of postoperative care is also provided to help in optimal healing for the patient.

Publication History

Publication Date:
25 February 2021 (online)

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