ABSTRACT
Eyelid rejuvenation surgery may be slowly shifting from pure fat removal techniques
to those that preserve and reposition the periorbital fat. The traditional subciliary
incision blepharoplasty was fraught with minor and major complications, and while
the transconjunctival blepharoplasty afforded lower morbidity, its inability to address
all aspects of periorbital rejuvenation eventually limited its popularity. Coincidentally,
a search by aesthetic surgeons was on for better techniques to lift the midface, soften
the nasolabial fold, and efface the tear trough deformity. In an effort to avoid the
lid malposition complications that often accompany transblepharoplasty cheek lifting,
innovative canthoplasty and canthopexy techniques were developed, which paved the
way for a safe return to subciliary blepharoplasty surgery. Effacement of the tear
trough deformity, now considered to be a major determinant in successful periorbital
rejuvenation, could be achieved through fat repositioning and without the use of alloplastic
implants or free fat grafts, thus improving reliability while minimizing complications.
By preserving periorbital fat the hollowed out orbit, often seen after traditional
blepharoplasty, could be avoided. The technique described in this article is a composite
of several previously published approaches, is simple for the experienced blepharoplasty
surgeon to master, and has been used with safety and reliability over the past 18
months in the senior author's practice.
KEYWORD
Blepharoplasty - SOOF - septal reset - canthoplasty
