Pros and cons for extended lower Blepharoplasty?

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.

Using an incision under the eyelash line will allow the surgeon to tighten the skin and muscle as well as deal with the fat that causes bags.  Every patient's needs are different and there are advantages and disadvantages to any blepharoplasty technique.  Consultation with your board - certified surgeon should help answer these questions.

Cons - scar, potential for ectropion, may weaken orbicularis musclePros - removes excessive skin, allows for lateral lift or canthopexyThis procedure, if done judiciously, will not result in major changes to your eye shape.  But if done aggressively, will potentially change the shape/size of your eye.  I now prefer the transconjuctival approach and pinch blepharoplasty where only the excess skin is removed on the outside.

The extended lower blepharoplasty is useful in patients that have a lot of redundant lower eyelid skin and fairly prominent periorbital wrinkles. A successful result depends on good incision placement, orbicular muscle suspension and a lateral canthopexy. Because it is a 'bigger' lower blepharoplasty the risks of lower eyelid retraction are greater and techniques must be done for its prevention.