Extended submuscular blepharoplasty with orbitomalar ligamen
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The aging appearance of the lower eyelid involves a combination of degenerative changes including excess lower eyelid skin, “bags” from lower eyelid fat pseudoherniation, under-eye circles from devolumization of the soft tissues overlying the infraorbital rim, and upper midface ptosis from redundant orbicularis oculi muscle. Our lower blepharoplasty technique addresses all these changes while preserving a robust orbicularis oculi sling and maintaining lower eyelid position with periosteal fixation of the lateral canthus and skin-muscle flap...

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