Orbicularis Muscle Folding Technique for Augmenting and Extra Support of Thin Anterior Lamella in Transcutaneous Lower Blepharoplasty.

[BACKGROUND] The orbicularis oculi muscle folding (OMF) is an innovative surgical approach in lower blepharoplasty that enhances the appearance of the lower eyelids.

[OBJECTIVES] To evaluate the use of OMF for auto augmentation of eyelid hollowness and to support the thin anterior lamella by folding the excess muscle upon itself rather than excising it for cosmetic purposes.

[METHODS] This single-arm interventional study was conducted in Sulaimaniyah, Iraq, from November 1st, 2021, to March 25th, 2023. Twenty patients, representing both genders, underwent lower blepharoplasty using the OMF technique.

[RESULTS] The mean age of the patients was 46.5 ± 2.1 years; most were females (90%). The average follow-up period was 14.55 ± 4.4 months. Most patients underwent bilateral surgery (95%) under local anesthesia (75%). Postoperatively, most patients were satisfied, and there were no unwanted complications; of the patients, 95% reported good results, while one patient (5.0%) reported fair results (p<0.001), and only 15% had canthopexy.

[CONCLUSIONS] The OMF technique provided the lower eyelid with a natural, tight, and fuller appearance, effectively addressing issues such as lower lid fat bulging or hollowness due to thin anterior lamella. This was achieved by supporting the anterior lamella with the folded muscle flap and its filling effect.

[LEVEL OF EVIDENCE IV] This journal requires that authors 43 assign a level of evidence to each article. For a full 44 description of these Evidence-Based Medicine ratings, 45 please refer to the Table of Contents or the online 46 Instructions to Authors http://www.springer.com/00266 .