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Lower eyelid - transcutaneous

Transcutaneous lower-eyelid approach

Principles

There are three basic approaches through the external skin of the lower eyelid to give access to the inferior, lower medial, and lateral aspects of the orbital cavity:

  • Subciliary (A, synonym: lower blepharoplasty)
  • Subtarsal (B, synonym: lower or mideyelid)
  • Infraorbital (C, synonym: inferior orbital rim)

The subciliary approach can be extended laterally to gain access to the lateral orbital rim (D).

The course of the incisions is aligned to the slope of the natural skin creases which become more apparent with age.
The skin of the eyelid is the thinnest in the human body. It has little or no dermis and almost no subdermal fat.
Hypertrophic scarring and keloid formation is very uncommon following lower lid skin incisions. In general, the scars become inconspicuous with time.