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Does lower eyelid surgery typically require snipping a muscle?

Q:

Does lower lid surgery typically require snipping a small wedge of the muscle under the eye where it attaches to the outer corner of the eye?

A:

Lower lid surgery is most dependent upon the patients anatomy and what is desired to be corrected.  If there is excessive baggy skin, festoons, etc. it is often necessary to use an external approach.  If simple puffiness or fullness is present, sometimes an internal or transconjuntival approach can be considered.  And, sometimes laser is even utilized to tighten the perioccular skin.  The approach taken is best determined by an experienced surgeon.  Look for an ASAPS member in your area to address your concerns.  They are experts in Occuloplastic Surgery.

Best,

 

Gary R. Culbertson, MD, FACS

A:

There are multiple ways to do lower eyelid surgery (blepharoplasty). One of these, and the one that gets the most improvement for significant aging, is to divide the skin and muscle under the eyelid, release the muscle from the orbital rim and elevate the whole cheek and eyelid. This does not cause any problem when done by someone with extensive experience. Other methods do not touch the muscle or only minimally do anything to it. If you are considering a blepharoplasty, what you will need is dependent on your age and the problem you have.

A:

Lower Eyelid Surgery and Transection of the Eyelid Muscles – In general, I do not disrupt the obicularis oculi (eyelid) muscle. I have not done this for 10 years as this can cause perioperative problems if not done in a judicious fashion. I believe in maximal obicularis preservation in both upper and lower cosmetic eyelid surgery.

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