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Gerald H. Pitman, Commentary, Aesthetic Surgery Journal, Volume 21, Issue 5, September 2001, Page 460, https://doi.org/10.1016/S1090-820X(01)70010-6
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Extract
Not too long ago the standard lower-lid blepharoplasty was limited to a subciliary incision, skin flap elevation (or skin-muscle flap elevation), and removal of fat from beneath the septum orbitale. Excess skin and muscle may or may not have been removed before closing. In the past 15 years, however, a plethora of techniques have been developed to address recently recognized anatomic pathology and to avoid complications of excessive skin excision, particularly with a lax lid or when lower-lid support is compromised.
Transconjunctival lower-lid blepharoplasty has successfully addressed bulging fat of the lower lid.1 Canthopexy and canthoplasty techniques can tighten and position the lower lid margin and lateral canthus,2–4 and varied mid-face lift techniques elevate cheek tissues onto the lower eyelid as a rejuvenating procedure involving the anterior lamella.5–6 The Loeb procedure,7 recently popularized by Hamra,8 transposes orbital fat to the face of the lower orbital rim to provide youthful fullness.
