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April 1990

Blepharoplasty in the Elderly Patient With Senile Lower Eyelid Changes: Combined Transconjunctival and Lateral Strip Technique

Author Affiliations

USN, Portsmouth, Va

Arch Otolaryngol Head Neck Surg. 1990;116(4):389. doi:10.1001/archotol.1990.01870040011002

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At the Southern Regional Scientific meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Dr Ira D. Papel, Baltimore, Md, White Sulfur Springs, WVa, described several of the most common undesirable appearances of the eyelids after lower blepharoplasty. Scleral show, rounded palpebral fissure, and ectropion in the senile lower eyelid can be minimized by careful preoperative evaluation and selection of one of several procedures designed to tighten or suspend the lower eyelid.

The lower blepharoplasty procedure preferred by the author for the senile lower eyelid is the combined transconjunctival and lateral strip technique. A 1-cm lateral can-thotomy is performed, transecting the inferior crus of the lateral canthal tendon. Fat removal is accomplished by incising the conjunctiva and approaching the orbital fat either through the orbital septum or behind the septum. The conjunctiva is then closed with a running 6-0 mild chromic suture in a subconjunctival plane. The

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