Search

Purpose: To describe a technique to correct lower eyelid malposition and lagophthalmos due to facial nerve palsy., Methods: Chart review was performed and identified 13 patients with facial nerve palsy, who presented with paralytic eyelid malposition and were treated with recession and extirpation of the lower eyelid retractors between September 2012 and March 2014 by 1 surgeon (HBL)., Results: A total of 12 eyelids in 11 patients met inclusion criteria. Mean preoperative MRD2 was 10 mm (range, 9.0-12.0 mm) and the mean postoperative MRD2 was 7 mm (range, 5.0-9.0 mm). The MRD2 improved an average of 3.0 mm in each patient (range, 2.0-4.0 mm). Patients had an average of 6.9 mm (range, 4.0-10.0 mm) of lagophthalmos preoperatively, which improved to 2.1 mm (range, 0.0-4 mm). The amount of lagophthalmos improved an average of 4.8 mm in the patients. There were no complications encountered in the patients. All patients had a subjective improvement in ocular comfort., Conclusions: The authors' surgical technique is effective in addressing lower eyelid malposition and ocular surface disease in paralytic lagophthalmos.

There are two main techniques of lower blepharoplasty: transcutaneous and transconjunctival approaches. Most patients seeking lower eyelid rejuvenation have concomitant involutional changes in the lower eyelid and midface, which would better be addressed concurrently with the lower blepharoplasty procedure to yield better aesthetic and functional outcomes. This study aims to review common aging-related changes in the lower eyelid as well as important preoperative considerations, surgical techniques, and various modifications of lower blepharoplasty. A literature search was performed in the PubMed database of English-language journals without restriction on the publication date using selected keywords. The relevant articles were selected by reviewing the titles and abstracts. The lower eyelid and midface should be perceived as a continuum. Currently the fat preservation approach is the mainstream in lower blepharoplasty to prevent postoperative skeletonization of the eye. Fat transposition, via either pedicled fat flaps or free fat grafts, is used to efface tear trough deformity and the eyelid-cheek junction as a primary aim inaesthetic lower eyelid surgeries. Lower blepharoplasty can also be combined with adjuvant procedures to address festoon and droopy midface in selected individuals. [ABSTRACT FROM AUTHOR]