• Xiao-Gen Hu, Yang Zhou, and Kai Ji.
• Plastic Surgery Department, China Japan Friendship Hospital, Beijing, China.
• J Chin Med Assoc. 2021 Feb 1; 84 (2): 191-196.

BackgroundTo investigate the effectiveness of the three-step supporting technique for prevention of eyelid malposition in the transcutaneous lower blepharoplasty.MethodsIt was a chart review of more than 10-year experiences of our method. From 2006 to 2017, a total of 697 patients underwent the three-step supporting technique in the transcutaneous lower blepharoplasty. The three steps included septum tightening, orbicularis canthopexy, and muscle plication. The assessment of outcome was made at 6 months. The results were assessed by evaluating pre- and postoperative appearance with Garcia-McCollough scale for lower eyelid overall appearance evaluation. The complication of eyelid malposition was evaluated in accordance with the grading system for post blepharoplasty eyelid malposition.ResultsAmong the 697 patients, 285 patients underwent fat excision and 412 received fat repositioning for correction of the trough deformity. The follow-up ranged from 6 to 36 months: 94.2% of the patients had improvement, 4.4% no improvement, and 1.4% poor results; 95.1% (n = 663) had almost normal position, 3.2% (n = 22) scleral show, only 1.7% (n = 12) mild eversion, no patient frank eversion. All the 12 patients with slight malposition recovered through conservative treatment.ConclusionThree-step supporting technique is safe and effective for lower blepharoplasty with minimal chance of eyelid malposition.Copyright © 2021, the Chinese Medical Association.

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