Orbital Septal Resection and the Hanging Curtain of Fat

PURPOSE: To describe a technique of lower eyelid blepharoplasty and report observations on 274 consecutive surgeries. METHODS: Retrospective, noncomparative case series of lower eyelid blepharoplasty by 2 surgeons from January 2004 through January 2006. RESULTS: Two-hundred seventy-four eyelids of 137 patients underwent transcutaneous lower eyelid blepharoplasty for the treatment of steatoblepharon. There were 27 men and 110 women with an age range of 35 years to 85 years. Minimum length of follow-up was 6 months. Two-thirds of patients had simultaneous horizontal lower eyelid tightening. Four patients (3%) had surgical enhancement for retained lower eyelid fat. CONCLUSIONS: With appropriate patient selection, orbital septal excision is an effective aesthetic technique for lower eyelid blepharoplasty. It combines surgical simplicity with good cosmetic outcomes.