This study analyzes the morphologic alterations of the lower eyelid after blepharoplasty by myocutaneous approach. Lower eyelid retraction and ectropion and are prevalent alterations, responsible for anatomic changes in the palpebral inferior contour. This condition is extremely compromising and has a complex management.
Methods/Technique:
Through medical record review from Ivo Pitanguy Institute, a retrospective study was performed from January 1995 to December 2005, looking for treatment of blepharoplasty complications. The authors analyzed clinical presentations, surgical treatment for the complications and the postoperative follow-up.
Results/Complications:
The authors found 20 patients submitted to surgical correction of lower eyelid retraction during the study period. All patients were Caucasians, sixteen were females, four were males and their ages varied from 37 to 82 years-old. A great variety of clinical presentations indicated different procedures: canthopexy alone in 3 cases, lateral canthotomy with canthopexy in 8 cases, tarsal strip in 7 cases, tarsal strip and skin graft in one case and skin graft alone in one case. These results showed that the clinical diagnosis was very important to guide successful surgical treatment. A single canthopexy is the treatment of choice for malposition of the lower eyelid presented as a scleral show. Canthotomy and tarsal strip procedures are indicated to moderate lid retractions. Skin grafts and posterior lamella procedures must be addressed to severe cases of lid retraction and ectropion.
Conclusion:
The Plastic Surgeon must have a careful approach on primary blepharoplasties and expertise on diagnoses and management of complications.