Modified lower eyelid blepharoplasty improves aesthetic outcomes in patients with hypoplastic malar prominences

Aim: Aging affects the appearance of the eyelids and the surrounding malar region. Blepharoplasty improves the aesthetic appearance of this region, and multiple variants of the procedure have been reported. We here report our technique for modified lower lid blepharoplasty and cheek lift for patients with hypoplastic malar regions, which was introduced after observing prominent lower orbital rims in patients with flat malar prominences after blepharoplasty. Methods: This technique combines standard canthopexy and cheek-lift for rejuvenation of the mid-face with redraping of orbital fat and concurrent sub orbicularis oculi fat pad (SOOF) lift to “double-breast” the lower orbital margin. Data on 33 patients who had undergone this modified lower lid blepharoplasty was collected retrospectively. Results: Thirty-three patients underwent the modified lower lid blepharoplasty resulting in smooth and youthful appearance of the malar region that was consistent and sustained. No recurrence of V-deformity was observed on a median follow-up of 14 months. Twenty-two (66.6%) and 11 (33.3%) patients were pleased and satisfied with postoperative outcomes respectively. Three (9.1%) patients experienced minor postoperative complications and no major complication was observed. Conclusion: The proposed modified lower lid blepharoplasty is a safe and effective alternative to the existing technique with improved aesthetic outcomes and therefore is recommended in patients with flat malar prominences. ABSTRACT