Pros and cons for extended lower Blepharoplasty?

Hello sprmom7,There are more risks with transcutaneous lower blepharoplasty procedures because of the incision and the vector forces which tend  to pull the lower eyelid downward; but having said that, I perform transcuaneous lower blepharoplasty procedures quite commonly.  Technique and experience are very important in preventing the pitfalls of the surgery.  The main risks for a transcutaneous surgery are a noticeable scar, lumps and bumps, hollowing of the eye, and ectropion (lid sagging).  When I evaluate the patient, I am always looking at the eyelids support mechanisms and anatomy.  Some eyelids have a tremendous amount of skin laxity, festoon, and ptosis of the orbicularis oculi muscle.  If the orbit does not protrude and the bony orbital rim is well-developed, I may op to extend the lateral incision and suspend the orbicularis oculi muscle to the bone to get more of an improvement of the lower eyelid region.  So, I think in the right patient, the extended lower blepharoplasty procedure can be a powerful surgery in refreshing someone.  Good luck and I hope this was helpful.

Transcutaneous lower blepharoplasty carries more risk of lower eyelid distortion, including ectropion, retraction, etc, resulting in unnatural appearance and eye closure issue. Extended version adds even more risk. Of course surgical technique is important as well.

I am not sure exactly what an extended blepharoplasty is, and I write articles on this topic.Aggressive lower blepharoplasty procedures have a very high chance to alter eyelid shape by pulling down in the center or the side of the lower eyelid, creating a surprised appearance and causing dryness of the eye.In our practice, we have given up on conventional blepharoplasty entirely in favor of the short incision cheek lift.  The dynamics are just better for lifting the cheek, thereby liberating skin either for reconstruction of a pulled lower eyelid or prevention of pulling down while allowing tightening of the lower eyelid skin.