I saw a patient today who was one of many patients I have seen with lower eyelid malposition after a blepharoplasty done elsewhere. This gentleman was bothered by the excessive show of the white part of his eyes because of a lower lid blepharoplasty that was done through an incision just below the eyelash line on the outside of the eyelid, called a “subciliary” incision. I do not usually perform this incision because of the potential for a pulling effect on the lower lid which exposes too much of the white portion of the eye below the colored portion of the eye, creating a sad or drawn appearance to the lower eyelids which I do not think this is acceptable; this is also called “lower eyelid malposition”. My preferred approach is through the inside of the lower eyelid, called the “transconjunctival approach”, which many surgeons are not comfortable with, but I feel that it is a superior approach for a lower eyelid lift (blepharoplasty).
For examples of results from eyelid lifts, please see our before and after gallery.
It is important to try to avoid lower eyelid malposition because it can be very difficult to treat. We have had success with filling of the mid face and cheek with a VolumeLiftSM, and this helps to lift the skin of the mid face and lower eyelid, while at the same time rejuvenating the cheek and lower eyelid area. For examples of patients who had a VolumeLiftSM, please click here.
