A critical analysis of the current surgical concepts for lower blepharoplasty.

This article discusses the new trends in lower blepharoplasty. Many different techniques have been described for the treatment of lower lid deformities, some favoring the transconjunctival approach that avoids touching the orbicularis oculi muscle, others recommending the muscle cutaneous flap. In some cases, maintenance of the fat is indicated, whereas in others its removal is recommended. To clarify such divergences, the author performed 100 blepharoplasties. The transconjunctival approach was performed with or without skin removal and with or without canthopexy, and the muscle cutaneous flap method was performed with or without fat removal and with or without canthopexy. The patients were followed up and observed for 6 months. The preoperative, intraoperative, and postoperative periods were analyzed. The patient, the surgeon, and a third person evaluated the results. Preoperative and postoperative photographs illustrate this article.