Prevention of eyelid malposition by three-step supporting technique in the transcutaneous lower blepharoplasty.

[BACKGROUND] To investigate the effectiveness of the three-step supporting technique for prevention of eyelid malposition in the transcutaneous lower blepharoplasty.

[METHODS] It was a chart review of more than 10-year experiences of our method. From 2006 to 2017, a total of 697 patients underwent the three-step supporting technique in the transcutaneous lower blepharoplasty. The three steps included septum tightening, orbicularis canthopexy, and muscle plication. The assessment of outcome was made at 6 months. The results were assessed by evaluating pre- and postoperative appearance with Garcia-McCollough scale for lower eyelid overall appearance evaluation. The complication of eyelid malposition was evaluated in accordance with the grading system for post blepharoplasty eyelid malposition.

[RESULTS] Among the 697 patients, 285 patients underwent fat excision and 412 received fat repositioning for correction of the trough deformity. The follow-up ranged from 6 to 36 months: 94.2% of the patients had improvement, 4.4% no improvement, and 1.4% poor results; 95.1% (n = 663) had almost normal position, 3.2% (n = 22) scleral show, only 1.7% (n = 12) mild eversion, no patient frank eversion. All the 12 patients with slight malposition recovered through conservative treatment.

[CONCLUSION] Three-step supporting technique is safe and effective for lower blepharoplasty with minimal chance of eyelid malposition.