Lower Blepharoplasty with Mid-Face Elevation: A Polydioxanone (PDO) Barbed Suture Loop for Lid–Cheek Junction Blending

Anti-aging in the lower eyelid–cheek junction area has always been the most widely sought cosmetic surgery. However, orbital fat removal or a midcheek fat pad lift alone does not achieve the best results. This study describes a new technique of lower blepharoplasty combined with a midcheek lift performed using a polydioxanone barbed suture loop based on the entire anatomy of the lower eyelid–cheek junction area.

We report our experience with lower blepharoplasty combined with a midcheek lift, covering 38 procedures performed over the past 3 years. We reviewed the technique and results and described the various indications for which the new technique is suitable. The efficacy of the surgeries was delineated using both 3D volume calculation and graphic pictures.

All patients demonstrated significant rejuvenation of the lower eyelid with the elimination of the eyebags, elevation of the lid–cheek junction, and improvement of the nasolabial folds. All the patients were satisfied with the procedure. Complication rates were low, and lower lid retraction temporarily occurred in 3% of patients.

This new method of lower blepharoplasty with midcheek elevation is safe, effective, convenient, and long-lasting. The technique is more doctor-friendly, recovery is quick, and complications are minimized.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.