Eyelid level after lower lid blepharoplasty with skin excision. The relationship of intraoperative and postoperative lid levels.

Sixty-seven consecutive patients (134 lids) undergoing lower lid blepharoplasty with skin excision had preoperative, intraoperative, and postoperative photographs taken in a sitting position. There was correlation between intraoperative and postoperative lower lid levels in 119 (89%) of 134 lids. There were nine lids with normal intraoperative lower lid level but postoperative lower lid retraction (scleral show). All nine of these lids had preoperative lower lid retraction. This demonstrated a high correlation between intraoperative and postoperative lower lid levels in the sitting position in lower lid blepharoplasty with skin excision, providing preoperative lower lid retraction is not present, horizontal lid laxity is corrected, and cicatricial lid retraction does not occur.