The transcutaneous lower-eyelid blepharoplasty is a commonly performed surgical technique and an important tool in the armamentarium of facial plastic surgeons. The facets of lower-eyelid blepharoplasty begin with proper patient selection and rely on several technical subtleties that are crucial to achieve an excellent cosmetic and functional result while avoiding potential complications. The senior author (S.W.P) has been using the transcutaneous approach with orbicularis oculi muscle suspension for 30 years to address redundant or excessive skin and muscle while gaining wide exposure to treat pseudoherniation of the orbital fat compartments.
Shadfar S, Perkins SW. Transcutaneous Skin-Muscle Flap Suspension Lower-Eyelid Blepharoplasty. JAMA Facial Plast Surg. 2015;17(6):459-461. doi:10.1001/jamafacial.2015.1332