Page 235 - Read Online

Khan et al. Plast Aesthet Res 2017;4:228-35 Plastic and
DOI: 10.20517/2347-9264.2017.69
Aesthetic Research

www.parjournal.net
Original Article Open Access

Modified lower eyelid blepharoplasty

improves aesthetic outcomes in patients with

hypoplastic malar prominences

Muhammad Adil Abbas Khan , Kanza Aziz , Ammar Asrar Javed , Mark Gorman , Diaa Othman , Muhammad Riaz 1
1
1
2
3
1
1 Department of Plastic and Reconstructive Surgery, Castle Hill Hospital, Hull HU16 5JQ, UK.
2 Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
3 Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Correspondence to: Dr. Ammar Asrar Javed, Department of Surgery, Johns Hopkins Hospital, Blalock 618, 600 N. Wolfe Street, Baltimore, MD
21287, USA. E-mail: ajaved1@jhmi.edu
How to cite this article: Khan MAA, Aziz K, Javed AA, Gorman M, Othman D, Riaz M. Modified lower eyelid blepharoplasty improves aesthetic
outcomes in patients with hypoplastic malar prominences. Plast Aesthet Res 2017;4:228-35.

ABSTRACT
Article history: Aim: Aging affects the appearance of the eyelids and the surrounding malar region.
Received: 25 Sep 2017 Blepharoplasty improves the aesthetic appearance of this region, and multiple variants
First Decision: 25 Nov 2017 of the procedure have been reported. We here report our technique for modified lower lid
Revised: 13 Dec 2017 blepharoplasty and cheek lift for patients with hypoplastic malar regions, which was introduced
Accepted: 14 Dec 2017 after observing prominent lower orbital rims in patients with flat malar prominences after
Published: 29 Dec 2017 blepharoplasty. Methods: This technique combines standard canthopexy and cheek-lift for
rejuvenation of the mid-face with redraping of orbital fat and concurrent sub orbicularis oculi
Keywords: fat pad (SOOF) lift to “double-breast” the lower orbital margin. Data on 33 patients who
Blepharoplasty, had undergone this modified lower lid blepharoplasty was collected retrospectively. Results:
malar complex, Thirty-three patients underwent the modified lower lid blepharoplasty resulting in smooth and
lower eye lid, youthful appearance of the malar region that was consistent and sustained. No recurrence of
modified blepharoplasty V-deformity was observed on a median follow-up of 14 months. Twenty-two (66.6%) and 11
(33.3%) patients were pleased and satisfied with postoperative outcomes respectively. Three
(9.1%) patients experienced minor postoperative complications and no major complication
was observed. Conclusion: The proposed modified lower lid blepharoplasty is a safe and
effective alternative to the existing technique with improved aesthetic outcomes and therefore
is recommended in patients with flat malar prominences.

INTRODUCTION eyelids and the surrounding structures including the
malar region. The malar prominence lies just inferior
Aging is an inevitable natural process of life that to the eyelid and is an important aesthetic component
affects all parts of the human body. Multiple age- of the eyelid-check junction. The concomitant loss of
related changes are observed in the anatomy of the the elasticity of the musculature (leading to laxity) and

Quick Response Code:
This is an open access article licensed under the terms of Creative Commons Attribution 4.0 International
License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution,
and reproduction in any medium, as long as the original author is credited and the new creations are licensed under the
identical terms.
For reprints contact: service@oaepublish.com

228 © The Author(s) 2017 www.oaepublish.com