New lower blepharoplasty technique for elderly patients using bony fixation of the sub-orbicularis oculi fat pad

ABSTRACT

Conventional sub-orbicularis oculi fat (SOOF) lifting during lower blepharoplasty is performed by anchoring the SOOF to the periosteum of the infraorbital rim. This procedure helps to improve the concavity at the central portion of the lower eyelid and the lid-cheek junction. However, over time, the periosteum becomes progressively weaker, diminishing the anchoring effect. This paper introduces a new lower blepharoplasty technique in which the SOOF is fixed to a bony hole to strengthen the holding force and provide sustainability.